Name (required)

Address

City

State

Zip

Email (required)

Phone

Birthdate

Male   Female

Emergency Contact Information (required)

Expected Dates of Stay (required)
From: To:

Describe relevant practice experience. (How long have you practiced and where, how many sesshins have you done, do you practice daily, etc.)

Zen practice is a highly demanding discipline and living in close community can be very stressful. Do you have any physical, mental or emotional challenges that would inhibit your practice or performance in house jobs or participation in a community environment?

Do you have any current alcohol or drug problems?

Please describe any prescriptions drugs you are taking or have recently taken.

Is there anything else we should know about?

What do you hope to experience by coming to AZC?

Have you read the description of the Guest Practice Program?
Yes   No

   

Press Submit to send this application, or you may print out this form and mail it to: Guest Pratice Manager, Austin Zen Center, 3014 Washington Sq., Austin, TX 78705. If you print out the form, you may use additional pages as necessary.