The 2nd Malaysia Satipatthana Meditation Retreat Registration Form 第二屆大馬四念處禪修課程報名表單 中文版本 English Version Registration Form Please enable JavaScript in your browser to complete this form. - Step 1 of 7Retreat Details☘️【Registration Form】 Chinese Form:www.shineling.org/retreat-form ☘️【Retreat Details】 www.shineling.org/retreat-en ☘️【Teachers】 Guiding teachers appointed by Luangpu Pramote Pamojjo: Ajahn Prasan Bhuddhakulsomsiri Ajahn Nat Sriwachirawat Ajahn Nitiya Petchpaibool Ajahn Napatpol Kunatanasate Ajahn Kittiya Pholkerd ☘️【Retreat Duration】5 Days 4 Nights Reporting Date/Time: Friday 12 April 2024, 7:30am Retreat Ends: Tuesday 16 April 2024, 6:00pm ☘️【Medium of Instruction】 Teachings will be delivered in Thai with English and Chinese translations. ☘️【Admission Quota】 200 pax including Old Students: 140 pax New Students: 60 pax ☘️【Retreat Venue】 KSL Esplanade Hotel, Klang The hotel is approximately 50km away from Kuala Lumpur International Airport (KLIA) Terminal 1 and 2. The organiser may arrange airport transfers for overseas students when necessary. ☘️【Food and Accommodation Fees】 ▎ Students need to pay for the food and accommodation themselves. ▎ Retreat teachings are given free of charge. ▎ Food and accommodation fees are calculated on a per person basis. Below are the options to cater to different accommodation needs: ▎Room Options 1. Single Bed Room – RM 1,250 per pax 2. Twin Bed Room - RM 980 per pax ▎ The above includes: 5 days 4 nights’ accommodation (check in on 12 April, check out on 16 April) 12 April: Lunch, Dinner and Tea Break 13 to 15 April: Breakfast, Lunch, Dinner and Tea Break 16 April: Breakfast and Lunch ▎ The above does not include: 1. Tourism Tax imposed by the Malaysian Government for all foreign passport holders for daily hotel stays in Malaysia. This amount will be collected in due time. 2. Airport transfers. 3. Rental fees for translation booth, devices, receivers, audio and video equipment. 4. Expenses incurred for COVID prevention, administration, teachers and translators flight, food and accommodation etc. ✅ Items 2, 3 and 4 will be borne by the organiser. ▎ Sangha Dana Please contact the organiser if you are interested to offer financial support to the Sangha for their participation in this retreat. ☘️【Organiser】 Shi Ne Ling Monastery The organiser reserves the right to make changes to the retreat. In case of disputes, Shi Ne Ling Monastery reserves the right of final decision. ☘️【Contact Information】 For enquiries, please use contact details below: Email: shineling.retreat@gmail.com WhatsApp: +6018-919 9096 WeChat ID: godhamma Next PageRegistration Criteria【Eligibility Criteria for Old Students only】 ⛳️ Eligible to apply and be interviewed by the teachers if he/she 1. had participated in any of the following retreat(s) in accordance with the method taught by Luangpu Pramote Pamojjo, ✅ Thailand Satipatthana Meditation Retreat ✅ Malaysia Satipatthana Meditation Retreat ✅ Online Satipatthana Meditation Retreat 2. had not been accepted for participation in the 13th Thailand Satipatthana Meditation Retreat 【Eligibility Criteria for Old Students who will be attending the 13th Thailand Satipatthana Meditation Retreat】 ⛳️ Eligible to apply but will not be interviewed by the teachers, unless there are excess available slots for the interview sessions, and must 📌 Participate in all the activities throughout the retreat except during breakout sessions. 📌 Clock at least 4 hours of formal practice per day during the first 4 days of the retreat. 📌 Clock at least 2 hours of formal practice on the last day of the retreat. 【Eligibility Criteria for New Students only】 ⛳️ Eligible to apply and be interviewed by the teachers if he/she 1. have not participated in any offline or online Satipatthana Meditation Retreat(s) in accordance with the method taught by Luangpu Pramote Pamojjo 2. had listened or watched at least 30 sessions of Luangpu Pramote Pamojjo’s teachings. 【Eligibility Criteria for Both Old and New Students】 ☘️ Required to participate in a two month pre-retreat cultivation and listen to designated teachings upon admission confirmation. If the attendance for the above falls short of the specified number of sessions, the student(s) may lose his/her eligibility to participate in the retreat. ☘️ Students must be physically and mentally healthy, be able to stay at the venue and participate throughout the entire retreat. ☘️ If the teacher deems that a student is no longer suitable to continue participating in the retreat, the student must accept the organiser’s arrangements without any condition. 【Registration Instructions】 ☘️ Admission confirmation will be sent via email and social media apps (such as WhatsApp, WeChat) by late January 2024. ☘️ Submission of registration form does not mean that your admission is successful. The guiding teachers reserves the right of final decision on the eligibility of the student. ☘️ During the retreat, lay students do not need to observe the eight precepts, but are required to voluntarily observe the five precepts. ☘️ There will be audio and video recordings of the entire retreat for the purpose of Dhamma-dana. Students are not allowed to request for deletion of recordings associated with his/her interview session. Students must ensure that he/she is willing to appear on camera before registering for this retreat. ☘️ Due to multiple restrictive conditions, the organiser will accept neither applicants without admission confirmation nor requests for services beyond this retreat (such as travel and accommodation arrangements for family members etc.). ☘️ During the retreat, family members who had not been admitted is not allowed to stay or participate in the retreat. Previous PageNext PageDeclarations And Undertakings1. Do you undertake to fill in the following details truthfully? *YesNo2. Have you ever participated in any Satipatthana Retreat(s) (offline/online) that is led in accordance with the method taught by Luangpu Pramote Pamojjo? *YesNoAttendance of more than one retreat is considered as having participated.3. Have you listened or watched at least 30 sessions of Luangpu Pramote’s teachings? *YesNo3. Have you been admitted as a participant in the 13th Thailand Satipatthana Meditation Retreat? *YesNoAs an old student, are you able to commit to, a) Participating in all the activities throughout the retreat except during breakout sessions. b) Clocking at least 4 hours of formal practice per day during the first 4 days of the retreat. c) Clocking at least 2 hours of formal practice on the last day of the retreat. *YesNo4. Are you able to commit to staying at the designated accommodation throughout the entire duration of the retreat, and participating in all activities independently? *YesNo5. Are you willing to cooperate fully with the organiser’s COVID-19 prevention measures E.g. Antigen Rapid Test (ART), isolation upon confirmation of infection etc.? *YesNo6. Are you able to commit to the two months pre-retreat cultivation? *YesNo7. There will be audio and video recordings of the entire retreat for the purpose of Dhamma-dana. Are you willing to appear on camera and not request for deletion of recordings associated with your interview session? *YesNo8. Are you willing to observe the five precepts? *YesNoSorry, you are not eligible for registration. Previous PageNext PageSorry, you are not eligible for registration. Personal ParticularsChinese Name (as per NRIC or passport) *English Name (as per NRIC or passport) *Dhamma Name (if any)Gender *MaleFemaleBirthdate *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Region/Nationality *MalaysiaMalaysiaSingaporeChinaHong KongTaiwanMacauThailandAustraliaUnited StateCanadaOthersNationality *Region/Country of Residence *MalaysiaMalaysiaSingaporeChinaHong KongTaiwanMacauThailandAustraliaUnited StateCanadaOthersState *JohorJohorKedahKelantanMelakaNegeri SembilanPahangPenangPerakPerlisSabahSarawakSelangorTerengganuKuala LumpurRegion/Country of Residence *Identity *Sangha Member (monastics)Lay Practitioner (lay person)Profession *Mobile Number (E.g. +60101234567) *Please include country code: Malaysia +60, Singapore +65, China +86, Hong Kong +852, Taiwan +886, Thailand +66Email *EmailConfirm EmailPlease fill in the correct email address as notification for the successful submission of the form will be sent through this email address.Preferred Social Media apps *WhatsAppWeChatIf you do not have access to the above, please provide the contact details of your next of kin so that the organiser can get in touch with you promptly.Please provide your WhatsApp number (E.g. 60101234567) *Please include country code: Malaysia +60, Singapore +65, China +86, Hong Kong +852, Taiwan +886, Thailand +66Please provide your WeChat ID *Please upload the WeChat QR code * Click or drag a file to this area to upload. In view of WeChat restrictions during addition of friends, please add the following WeChat ID as your friend in advance to ensure that we can contact you upon admission confirmation. Retreat's WeChat ID: godhamma Please upload a photo that meets the requirements below: * Click or drag a file to this area to upload. 1. Taken within one month from to date. 2. Face must be clearly visible. 3. Taken with adequate lighting. 4. Original without retouching or beautification. 5. File size no more than 10MBPrevious PageNext PageSorry, you are not eligible for registration. Survey on Dhamma Learning ExperienceHave you ever participated in Thailand’s 10 Days Satipatthana Meditation Retreat led in accordance with the method taught by Luangpu Pramote Pamojjo? *YesNoWhich of the following Thailand Satipatthana Meditation Retreat did you attend? (check all options that apply) *1st Thailand Satipatthana Meditation Retreat2nd Thailand Satipatthana Meditation Retreat3rd Thailand Satipatthana Meditation Retreat4th Thailand Satipatthana Meditation Retreat5th Thailand Satipatthana Meditation Retreat6th Thailand Satipatthana Meditation Retreat7th Thailand Satipatthana Meditation Retreat8th Thailand Satipatthana Meditation Retreat9th Thailand Satipatthana Meditation Retreat10th Thailand Satipatthana Meditation Retreat11th Thailand Satipatthana Meditation Retreat12th Thailand Satipatthana Meditation Retreat13th Thailand Satipatthana Meditation Retreat (Admitted)Did you participate in Malaysia’s 1st Satipatthana Meditation Retreat? *YesNoHave you ever participated in the Online Satipatthana Meditation Retreat led in accordance with the method taught by Luangpu Pramote Pamojjo? *YesNoWhich of the following Online Satipatthana Meditation Retreat did you attend? (check all options that apply) *1st Online Satipatthana Meditation Retreat2nd Online Satipatthana Meditation Retreat3rd Online Satipatthana Meditation Retreat4th Online Satipatthana Meditation Retreat5th Online Satipatthana Meditation Retreat6th Online Satipatthana Meditation Retreat7th Online Satipatthana Meditation RetreatHave you ever participated in the International Course in English guided by Ajahn Prasan in Thailand? *YesNoHave you ever been selected to receive one-on-one guidance from Ajahn Prasan Bhuddhakulsomsiri, Ajahn Nat Sriwachirawat, Ajahn Nitiya Petchpaibool, Ajahn Napatpol Kunatanasate, Ajahn Kittiya Pholkerd in the monthly Zoom meditation interview sessions? *YesNoHow often do you listen to or watch Luangpu Pramote Pamojjo’s weekly Dhamma live stream on Saturdays and Sundays, and Ajahn Prasan Bhuddhakulsomsiri’s twice monthly Dhamma live stream? *RegularlyRegularlyFrequentlyOccasionallyNeverHave you ever listened or watched the complete set of teachings from any one of the previous Thailand Satipatthana Meditation Retreat? *YesNoDo you observe the five precepts? *YesNoHow often do you carry out the formal practice? *DailyDailyFrequentlyOcassionallyNeverApart from Luangpor Pramote and the appointed teachers, such as Ajahn Prasan Bhuddhakulsomsiri, Ajahn Nitiya Petchpaibool, etc., are you currently studying meditation with other teacher(s) ? *YesNoPlease indicate the teacher(s) you are currently studying with *Previous PageNext PageSorry, you are not eligible for registration. Translation LanguagePlease select the option that best describe your understanding of the language. Fluency: This is my mother tongue or language I am most proficient in. I can use this language fluently in reading, listening, communicating, writing, including expressing complex perspectives and emotions. Moderate Proficiency: This is the language I am familiar with. I can use this language to read, listen, communicate and write in daily life and at work, but it is not as conversant and fluent as my mother tongue. Basic Proficiency: I can use this language to speak and communicate with others briefly to manage basic living needs, but I cannot understand complex content, neither can I read abstruse writings nor express complex perspectives and emotions fluently. No Proficiency: I need the help of a translator to understand and communicate in this language. Chinese Proficiency *FluencyFluencyModerate ProficiencyBasic ProficiencyNo ProficiencyEnglish Proficiency *FluencyFluencyModerate ProficiencyBasice ProficiencyNo ProficiencyThai Proficiency *FluencyFluencyModerate ProficiencyBasic ProficiencyNo ProficiencyTranslation Language Options Please select the language you are familiar with During The Retreat *ChineseChineseEnglishThaiTo listen to teachings and guidance from the teachers during the retreat.During Interview Sessions *ChineseChineseEnglishThaiTo interact with teachers and answer the questions promptly.During Pre-retreat Cultivation *ChineseChineseEnglishTo watch videos with simultaneous translation or subtitles.Previous PageNext PageSource of Retreat InformationHow did you know about this retreat? (check all options that apply) *WebsiteAppWhatsAppFacebookInstagramYoutubeWeChatTelegramNewspaperWord of mouthOtherPlease specify *Who recommended this retreat to you? *FriendTemple or MonasteryMonastic or TeacherPlease proceed to submit the form.Thank you for your patience in answering the above questions. Please proceed to submit the form. Admission confirmation will be sent via email and social media apps such as Whatsapp and WeChat. ▎I hereby declare that all the information provided is true and accurate. I agree and accept all the decisions and arrangements made by the organiser. ▎After submission, you will receive an email notification that the form had been submitted successfully. If you do not receive this email within 24 hours of submission, it means that the form may not have been submitted successfully. Please contact the organiser immediately. 【Organiser】 Shi Ne Ling Monastery The organizer reserves the right to make changes to the retreat. In case of disputes, Shi Ne Ling Monastery reserves the right of final decision. 【Contact Information】 If there are any retreat enquiries, please inquire through the following; Email: shineling.retreat@gmail.com WhatsApp: +6018-919 9096 WeChat ID: godhamma ----------------------------- Shi Ne Ling Monastery Website: www.shineling.org App: https://www.godhamma.alicloud1688.com/ Sorry, you are not eligible for registration. Previous PageSubmit