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Registration
Individual Registration
A Soft and Radical Transformation of the Heart: A Weekend Metta Retreat
First Name
*
Last Name
*
Street Address
*
City
*
Zip
*
Country
*
Select country
Canada
United States
Province
*
Select Province / State
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Nunavut
Northwest Territories
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Home Phone
*
Work Phone
Cell Phone
Email
*
Confirm Email
*
Emergency Contact Person
*
Emergency Contact Person Telephone
*
Personal Information
This information helps us make your retreat experience as smooth as possible.
Gender
*
Male
Female
Transgender or gender diverse (e.g. gender fluid, gender queer, agender)
Year of Birth (YYYY)
*
Do you snore?
*
Yes
No
Meals will be vegetarian with dairy and eggs. We cannot always accommodate special needs. If you have any special dietary needs for health reasons, please explain here.
Special Dietary Needs
Dairy Free
Wheat Free
Gluten Free
Other
Please explain your special dietary needs
Please indicate any physical disabilities or special needs to assist in assigning your room.
Special Needs
Indigenous Peoples and People of Color
As part of TNI's commitment to diversity and equity, we have the intention to increase the participation of People of Color and Indigenous Peoples in our retreats. To help bring this to fruition, we are holding a portion of all retreat spaces for Indigenous Peoples and People of Color (PoC). Unused slots reserved for Indigenous Peoples and PoC will be released 6 weeks prior to the start date.
So we can support your participation in the retreat of your choice, please make us aware if you self-identify as an Indigenous Person or as a Person of Color
*
Yes
No
Mailing List
Your name, address, phone number and email address will be entered into our computer database so you can receive information about future retreats. We do not sell or share our mailing list with other organizations.
Mailing list subscription:
Yes, I would like to be on the mailing list
Meditation Experience
Have you attended a TNI retreat before?
*
Yes
No
Have you attended a retreat elsewhere before?
*
Yes
No
Have you previously practiced insight meditation (vipassana)
*
Yes
No
With which teachers, where and for how long?
Have you practiced any other type of meditation?
*
Yes
No
Please give details:
Ride Share
Ride-sharing is a great way to simplify retreat transportation while being conscious of our impact on the environment
Would you like to participate in ride-sharing?
*
Yes
No
Would you like to offer or receive a ride to the retreat?
*
Offer
Receive
I can offer a ride to
*
--Select--
1 person
2 person
3 person
4 person
5 person
6 person
From where will you be travelling?
*
Scholarships
Scholarships are awarded on the basis of financial need only and offer up to a 50% discount off the low rate.
Would you like to apply for a scholarship for this retreat?
*
Yes
No
Scholarships are awarded on a first come, first served basis. We are only able to offer partial scholarships, and must restrict scholarships to one per person, per year; only a limited number of scholarships are available for each retreat. All retreats require a deposit on registering, even if you are applying for a scholarship. The deposit for someone applying for a scholarship is the same as regular applicants.
How much can you pay for this retreat?
Scholarship amount requested
Occupation
Annual income
Number of dependents
Please describe the circumstances due to which you need financial assistance to attend this retreat
Retreat Fees
TNI is dedicated to offering affordable rates to all. We offer a sliding scale with low, mid and high rates that allow retreatants to pay according to their means. Paying at the low rate covers the minimum expense of holding a retreat. The cost of attending a TNI retreat even at the high end of the sliding scale covers only a fraction of our total expenses. Please pay at the highest level of the sliding scale you can afford. The deposit is included in all of our fees. Please note that the retreat fees pay for your room and three meals a day. This does not include payment to the teacher. Following the 2,500-year-old Buddhist tradition, the teachings are considered priceless and so are offered freely. At the end of the retreat you wil be invited to offer dana, or donations, to the teachers, the retreat manager and TNI.
Sliding scale amount you will pay?
*
$395
$460
$510
* Note that a minimum deposit payment of $200 is required to register for this retreat.
Donation
Please consider making a tax deductible donation, as retreat fees cover only a portion of our total expenses.
Would you like to offer a donation to TNI today?
Yes
No
How would you like to designate your donation?:
--Select--
General Donation to TNI
Scholarship Fund
What amount would you like to give to TNI today?
Payment
Please specify the payment method you wish to use
*
Online with Paypal
Interac e-transfer
Check
Payment Information
Amount
$
Payment Method
Pay offline
Billing Zipcode
*
Credit Card Number
*
Expiration Date
*
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02
03
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05
06
07
08
09
10
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2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
Card (CVV) Code
*
Card Type
*
Visa
MasterCard
Discover
American Express
Card Holder Name
*
By registering for this event, I accept
Terms and Conditions
Verification code
*