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search
About us
History
Testimonials
Ethics Policy
Schedule
In-Person Practice Schedule
Online Practice Schedule
Programs
Calendar
Retreats
One Day Retreats
Kido (chanting) Retreats
YMJJ
Christian-Buddhist Retreats
Solo Retreats
Kyol Che
Rentals
Rentals
Main Meditation Hall
Upstairs Meditation Room
Diamond Hill Monastery
Overnight Accommodations
General Accommodations
Teachings
Teachers
Dharma Teacher Resources
Wake Up Video
Forms of Practice
Visit
Residency
Guest Stays
Resident Application Form
Giving
Donate
Membership
Volunteer
Amazon Smiles
Contact
Please Fill Out The Form Below
Consent
*
I understand that there may be people without a Covid-19 vaccination on the Providence Zen Center property.
Unvaccinated people will NOT be attending the retreat
Vaccination Proof
*
All Kyol Che retreatants are required to show proof of vaccination.
Please have your vaccination card with you upon arrival or send a copy to director@providencezen.org
Proof of Negative Test Result
*
All Kyol Che Retreatants are required to show proof of a negative PCR test result within a week of their entrance date.
Please have your proof of a negative PCR test result with you upon arrival or send a copy to director@providencezen.org
Name
*
First
Last
Phone
*
Email
*
Gender
*
We'll assign shared rooms by the same gender.
Male
Female
Prefer Not to Answer
What is your age-range?
*
Again, this information will help us with room assignments.
Under 18
18-24
25-34
35-44
45-54
55-64
65 or Above
What precepts have you taken?
*
None
Five
Dharma Teacher in Training
Dharma Teacher
Senior Dharma Teacher
Bodhisattva Teacher
JDPSN / Zen Master
Monastic
Other Lineage
Please indicate your previous retreat experience, if any:
*
Kwan Um School of Zen is abbreviated: KUSZ
KUSZ Winter Kyol Che
KUSZ Summer Kyol Che
KUSZ Yong Maeng Jong Jin
KUSZ Kido Chanting Retreat
KUSZ Christian-Buddhist Retreat
KUSZ Fountains of Zen Workshop
Japanese
Vipassana
Tibetan
Vietnamese Zen
No Previous Experience
Other
Are you currently a dues paying member of the Kwan Um School of Zen?
*
Yes
No
Have you sat any 1- or 2-day retreats in the Kwan Um School of Zen?
*
Yes. No orientation needed.
Yes but I need a refresher.
No. I'll need an orientation.
When will you be entering the retreat?
*
2/25/2022
3/12/2022
3/21/2022
When will you be exiting the retreat?
*
2/25/2022
3/23/2022
4/2/2022
Are you a full-time student, senior citizen (over 65) or clergy member?
*
Yes
No
Do you have any medical or dietary issues?
Anything else you wish us to know?
Are you currently a member?
*
yes
no
Total
$0.00
Payment Method
*
PayPal Checkout
Credit Card
MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number
Expiration Date
Security Code
Cardholder Name
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