Mindful Living and Service Program Application

MLS Program June 1st – Aug 1st 2019

Morning Sun Immersion Opportunity Application 2020

Personal Information

Your Full Name *

Email Address *

Phone Number *

Additional Information

Your Age *

Mental and Physical Health

Please share with us any known physical health issues, medications, mental illness, previous experiences of mental illness, allergies to medications or products, that we should know about. Mental illness can range from depression, anxiety, schizophrenia, insomnia, eating disorders, and so on. Please be as specific as possible so that we can learn how to support you.

Health Insurance *

I have current health insurance

I do not have health insurance

Other Notes, Messages, Things We Should Be Aware Of

Emergency Contact

Emergency Contact Full Name *

Emergency Contact Email *

Emergency Contact Phone Number *

References

Please provide a reference. This could be an employer, teacher/mentor, professional acquaintance, sangha friend/facilitator, etc.

Reference Full Name *

Reference Relationship to You *

Reference Phone *

Reference Email *

Written Information

Meditation and Mindfulness Experience *

Please briefly summarize your experience with meditation, mindfulness, and the teachings of Thich Nhat Hanh.

Skills and Interests *

Please write a short list of personal passions, skills and work experience.

Statement on Intentions *

Please write a short statement that includes: why you wish to participate in program, what you hope to gain from the program, and how you see that you can contribute.

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Pressing the Submit Button will submit your application to MorningSun. Looking forward to seeing you soon!