Transcendental Meditation Weekend Retreat Application
Please complete this form for enrolment in the TM Weekend retreat at Mount Carmel Spiritual Centre in Niagara Falls taking place from November 7-9.
Personal information
Name
*
First Name
Last Name
Which pronoun do you prefer to use?
*
Please Select
He/Him
She/Her
They/Them
Other
Email
*
example@example.com
Mobile/Text Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Home Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Next, we'd like to understand your TM learning journey.
TM Centre
Please Select
Toronto TM Centre
Mississauga TM Centre
Hamilton TM Centre
Other
Date of TM Instruction
-
Month
-
Day
Year
Date
Location of TM Instruction
Name of TM Instructor
Is this your first TM retreat?
*
Have you received instructions in any TM advanced programmes?
Yes
No
Which of the advanced techniques have you completd?
AT 1
AT 2
AT 3
AT 4
Have you completed any part of the TM-Sidhis Program?
Yes
No
Other
To ensure that your stay at the retreat is as comfortable as possible please let us know the following
Special Dietary needs
Allergies
Special considerations regarding learning Yoga Asanas and Pranayama
To best serve you, please state any health or physical issues of which we should be aware of
Accessibility
The Mount Carmel facility is wheelchair accessible. With ramps and an elevator. However the ensuite bathrooms are not fully customized.
Do you have any learning or accessibility needs — mobility, visual, or auditory?
Billing information
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please select your preferred payment type.
*
Debit card (Visa/Mastercard)
Credit card (Visa or Mastercard)
To help serve you best, please complete the application and "Submit."
Once your application is received and processed, we will send a confirmation along with your invoice for the retreat. We look forward to hosting you during your stay. David and Suzanne
Submit
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