Pine Mountain Buddhist Temple & Meditation Retreat

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VISITING

Daily Practice

Day Visits

REGISTRATION

If you would like to stay the Pine Mountain Buddhist Temple please complete the registration below. You may type in your information and press the Submit Form button or you may print your completed application and mail it to Pine Mountain Buddhist Temple, 941 Lockwood Valley Road, Maricopa, CA 93252. Upon receiving your application, one of the monks will contact you regarding the details of your training period at the temple.

Please complete all fields as completely as needed and return this form by clicking the SUBMIT button below. If something does not apply, please put in "none".

Please Note: All of the following fields are required. If you get an error message after pressing the "submit" button, try clicking on the back button and check for any missed fields. Thank-you for your interest

Pine Mountain Buddhist Temple Registration Form
Date
Name
Date of Birth
Marital Status
Gender	Male Female
Email Address
Street Address City, State and Zip Code Country
Telephone
How did you hear about us?
Emergency name and phone number.
I would like to spend the following month (s) or dates as a resident lay trainee at Pine Mountain Buddhist Temple.
Please describe your previous experience with Buddhism and meditation.
Have you ever suffered from depression, or been diagnosed as having depression or another mental or psychological illness? If yes, please describe your condition and how it is being treated.
Do you have any physical limitations which would make it difficult for you to join in working meditation projects such as gardening, firewood stacking, cleaning, carpentry, etc.?
We keep to a simple (not vegan) vegetarian diet. Do you have food allergies which would require special consideration in what you eat?
Are you currently taking any prescription drugs or medication? If yes, describe.
Do you have any chronic illness or allergies?
Please describe your goals, hopes or wishes with respect to Buddhist practice, and in particular the time you would spend at Pine Mountain Temple.
Pine Mountain Temple operates on the basis of Dana, Dana is the ancient Buddhist practice of giving and receiving. Monks and lay people together sustain the Temple by being generous with all they have to offer. Generosity is the first sign of Enlightenment and the practice of generosity opens one’s heart to the Dharma. Pine Mountain Temple has no source of income other than your kind donations, which are the traditional way to show appreciation for the Teaching of the Buddha. By making an offering of money you participate in the existence of the Temple and the merit of such action will benefit all beings.

Pine Mtn. Buddhist Temple Stupa

A Temple of the Order of Buddhist Contemplatives
Contents by Pine Mountain Buddhist Temple available under
Creative Commons Attribution-Noncommercial-No Derivative Works License.