Sesshin Application Test This is a test version of the sesshin application: Application for May Sesshin at Tahoma NameFirstLast Email* Phone Current Address (optional) Street Address City State / Province / Region Postal / Zip Code AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongoCongo (Brazzaville)Costa RicaCote d'IvoireCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth MacedoniaNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWalesYemenZambiaZimbabwe Country Gender*MaleFemaleOther Age Schedule The Samu Osesshin and Samu Kosesshin led by Harada Roshi have extended samu in the morning.The Kosesshin led by Chisan Zenni will have a short samu and longer zazen in the morning.Sesshin start the evening of the first date. Informal supper will be served at 4pm.Mandatory orientation is at 5pm. Sesshin ends the evening of the last date (9:30pm).Attending sesshin is a commitment to full-time participation.You are welcome to arrive in the days before sesshin and stay after sesshin.Significant work is needed to set-up for sesshin and clean-up afterward. Please expect to make a contribution to this work. Samu Osesshin led by Harada Roshi. Kokuho the night of the 5th., continuing to the night of the 12th.I request a seat Samu Kosesshin led by Harada Roshi. Kokuho the night of the 13th., continuing to the night of the 15th.both days1415 Kosesshin led by Chisan Zenni. Kokuho the night of the 17th., continuing to the night of the 22nd.attend all days1819202122All sesshin choices are blank, please select atleast one Do you need to sit in a chair in the Zendo:*AlwaysSometimesNo Housing Option*TempleCampingOff-site If Housing is Off-Site, provide address and phone:Practice History Dharma name Jukai Preceptor Jukai (taking Precepts) Date01020304050607080910111213141516171819202122232425262728293031day / JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecembermonth / 20192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919191819171916191519141913191219111910190919081907190619051904190319021901year Ordination with - Ordination Date01020304050607080910111213141516171819202122232425262728293031day / JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecembermonth / 20192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919191819171916191519141913191219111910190919081907190619051904190319021901year First time Applicants, please provide a brief practice historyEmergency Contact, information is required Emergency Contact*FirstLast Emergency Phone* Emergency email Relationship to you*Medical Background Food served at Tahoma is vegetarian. Please list any serious food allergies and restrictions; any medical problems or concerns; and any physical or other conditions limiting participation in the schedule. Do you carry an Epi-Pen*NoYes Medical Training; if you have, please let us know - RN, EMT, MD?PaymentOsesshin fee is $400, and for Kosesshin $60 per day. Do you need financial aid to attend? You're required to arrive a day or more early or leave a day or more afterward to assist with Temple work.*NoYes Use PayPal now for Sesshin Fee?YesNo Sesshin Fee or Deposit -> Goes to PayPal and Submits Application USD I consent to the collecting of this data and processing it according to Privacy Policy of this website.SubmitReset
