Personal Retreat Application

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Personal Stay or Retreat Booking Application

Please fill out the form below. A member of our retreat office will get in touch with you soon to confirm availability and discuss your stay. You are welcome to stay for a short visit to the area or for a practice retreat of short to long lengths.

Please note: All questions are required except for those marked with an *

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- Step 1 of 3

Please verify

Have you read all the information on our website about Kalapa Guidelines on the previous page

Personal Information

Full name (as in passport) *

Email Address *

Nationality

Country of residence

Date of Birth

Gender (For shower rooms and accommodations)

What type of practitioner are you?

Are you Buddhist?

If yes in what tradition and lineage(s) are you practicing and for how many years?

Dates

Are you here for a visit or for a retreat?

How long are you planning to do stay?

Which dates would you like to come? *

Please select date range, in your order of preference

Are your dates flexible?

Do you have any other dates you want us to check availability?

As you are staying longer than 10 days, Will this or another close teacher be available in case you encounter difficulties in your practice during the retreat?

If so, please give contact details.

Name

Phone

Retreat Details

Can you tell us what type of retreat you wish to do at while at Kalapa? Do you have a daily retreat plan andHow long have you been studying and practicing Buddhism? In which tradition?

Are you hoping to do your practices in the gompa?

If yes what practices?

Have you ever done a strict practice retreat before? (i.e. doing 4 sessions of PRACTICE each day—this does NOT include courses)

What kind of retreat are you planning to do? (e.g. meditation, yoga, deity practice, ngondro practice, shine)

Have you been advised by a lama / close teacher to do this particular retreat?

If yes, specify your teacher's name

Why do you want to do this retreat?

Mental & Physical Health

Do you have any medical condition that may affect the retreat? Please note that Kalapa is in the mountains over 30 minutes by car to the nearest hospital and up to 1 hour by ambulance (for response and to get there) to the nearest medical.

If yes, please give details

Do you have any history of serious mental health problems?

Have you lately / presently been experiencing severe emotional stress or depression?

If yes to either question, do you feel stable and relaxed enough to participate on this retreat, given that we cannot provide one-on-one counselling? Please give details.

How did you learn about Dzokden Kalapa?

Please select one

Please specify

Is there anything else you think we should know?

Dzokden Kalapa– Verein zur Förderung von Frieden und Harmonie
We are a retreat center guided by Shar Khentrul Jamphel Lodrö Rinpoche. We are dedicated to creating a golden age of peace and harmony.
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