Application Form for Monk, Nun and Lay Yogi

Application Form for Monk, Nun and Lay Yogi

Please fill up this form correctly. You are required to produce your Malaysian lD card and/or passport for proper verification. Foreign monk ( and/or nun may require a recommendation letter from Upajjaya. The form must be submitted 10 days before your arriving.
Full Name*

First NameLast Name
Passport Size Photo*
Only gif, jpeg, jpg, png are accepted and maximum file size is 2Mb
Malaysian IC No
Date of Birth*

DayMonthYear
Date
Nationality*
Passport No
Age*
Religion*
Gender*

MaleFemale
Marital Status*

SingleMarried
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
House Phone Number

Area CodePhone Number
Mobile Phone Number

Area CodePhone Number
Email*
example@example.com
Highest Educational Qualification*
Profession*
Place of Work*

State briefly, your most recent retreat(s):

	Year of Retreat	Type of Meditation	Monastery/Master Name
1
2
3

Emergency Contact
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
House Phone Number*

Area CodePhone Number
Mobile Phone Number*

Area CodePhone Number

Section Filled by Monks or Nuns Only
Foreign monk or nun, may need recommendation letter from their Upajjaya.
My Monk's Name
My Nun's Name
How Many Vassa?
Status

BhikkhuSamaneraNunAnagarika
Donation
Any amount of Donation is welcome to various temple funds:
a) Dayaka Fund (Daily Maintenance)
b) Sangha Yogi Free Meal Fund (RM500/-)
c) Sangha Fund
d) Building Fund

You can transfer your donation to MBMC Maybank Acc: 507246185533. Please whatsapp us your Proof of Payment to +6012-7929 355 by providing your name and state clearly which fund you would like to donate for.

Declaration and Indemnity Clauses
Declaration and lndemnity Clauses. Please read carefullv.

I attest that the information given in this application form is true and correct. I undrestand that the centre reserves the right to reject my application and/or ask me to leave should the information, in whole or in part, prove to be materially untrue and incorrect.

Furthermore, I shall not hold MBMC or the sangha responsible and/or liable for any mishap, untoward occurrence, physical mental illness that may occur before, during and/or after my retreat.

I undretake to abide strictly by the rules of this centre, to pratice sincerely and conscientiously, and to follow closely the instructions of the meditation teacher.

I will not hold the centre liable and/or responsible for and items lost in its premises. I understand that the full payment for my retreat will not be refunded in the event that l terminate the retreats unexpectedly.
1. You are advised to place your monies, personal valuables and traveling documents with the office for safekeeplng.
2. Items kept in the office is at owner’s risk.
3. Please inform the office if there is any change in your date of departure.
4. All yogis are required to pay a nominal charge for food and accommodations per day to assist in detraying the cost of maintaining the centre.
  - Fees for the first 10 days for local (RM5/day) & foreigner (RM20/day).
5. lf you find that you have benefited from the pratice, and would like to contribute to help us maintain the centre and its meditation tradition, we would welcome it.
6. Personal items to bring:
  - Own toiletries
  - Mosquitos repellant
  - Personal medication
Important Note:
- Arrival after office hours will not be accepted for accommodation.
- Office Hours: 9am - 5pm
- Sunday & Public Holidays: 9am - 2pm.

Section filled by Child's Parent / Guardian Only
Acknowledged and signed by the parent/guardian before allowing the child (below 18 years old) to practise meditation in the centre
Name of Parent / Guardian

First NameLast Name
Name of the Child

First NameLast Name
I, read and understand the rules & regulation of the centre, I hereby agree to bear all responsibility for my child during his/her stay in MBMC

Signature Clear
Parent / Guardian

FatherMotherGuardian
IC Number
Passport Number
Name

First NameLast Name

Application Form for Monk, Nun and Lay Yogi

Medical History

SOP for COVID-19

MBMC Meditation Retreat

Donation

Acknowledged and signed by the parent/guardian before allowing the child (below 18 years old) to practise meditation in the centre