Metta Dharma Foundation
JIKOJI RETREAT APPLICATION
Los Gatos, CA
April 16 to April 25, 2010 with Richard Shankman
For further information or questions please contact info@richardshankman.org
The cost of the retreat is $675. The retreat fee covers the cost of the retreat facility rental and food only.
The teacher and cook(s) will be serving without compensation. At the end of the retreat, participants will
have an opportunity to offer whatever dana, or donation, they wish to the teacher and the cook(s).
To reserve a place at the retreat, please send in your completed (a) Application, (b) Participation Agreement
and Liability Release, and (c) a $150 deposit (payable to Metta Dharma Foundation) to:
Metta Dharma Foundation
79 Templar Place
Oakland, CA 94618
Full payment is due at retreat check-in.
Your $150 deposit will be fully refunded if you cancel your reservation by January 15th, 2010. If you cancel
between January 16 and February 15 your refund will be $100. If you cancel between February 16 and March
15 your refund will be $50. No refund if you cancel after March 15. Regardless of when you cancel your reservation,
we will refund the full amount of your deposit if we are able to fill your slot in the retreat.
Location: Jikoji Zen Retreat Center, 12100 Skyline Blvd, Los Gatos, CA 95030, 408-741-9562.
Refer to the Retreat Information Sheet for location details and directions to the retreat center.
Arrival and registration will occur from 3:30 to 5:30 p. m. on Friday, April 16, followed by a light supper.
The retreat will end by 3:00 p.m. on Sunday, April 25, 2010.
This retreat will be conducted in silence with a full daily schedule of sitting and walking meditation practice. Richard will be
offering meditation instruction, Dharma talks, and meditation practice interviews. Participants will be asked to observe five
precepts of ethical behavior during the retreat: 1) refraining from harming living beings, 2) taking what is offered and
refraining from stealing, 3) refraining from sexual activity, 4) maintaining noble silence, and 5) refraining from the use of
drugs and alcohol (prescription and other needed medications should be taken as required). Please refer to the retreat
information sheet for full details about the retreat and the five precepts.
Please Print Clearly:
Name__________________________________________________________________________________
Address____________________________________ City_____________________ State____ Zip_________
Phone (eve)______________________ (day)________________________ (cell)_______________________
Email ___________________________________ Birth Date _________________ Gender: M__ F__
Do you plan to camp? __________________
Emergency Contact:
Name__________________________________ Phone_________________ Relationship________________
Meditation Retreat Experience (This retreat is appropriate for beginning and experienced meditators)
Please list your most recent vipassana(insight) or concentration retreat experiences (teacher, location, length, and approximate dates):
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Please list other retreat experiences you have had ___________________________________________
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Dietary and Medical Restrictions:
Please circle your dietary restrictions: no dairy no wheat no eggs other ______________________
Please describe any special medical needs or mobility limitations: ______________________________
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Carpooling Is Necessary Due To Limited Parking at Jikoji:
Can you provide transportation for others? Yes No If yes, for how many? _________
Do you need transportation? Yes No
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