Retreat form "*" indicates required fields Name* Full Name Email* PhoneAddress* City State / Province / Region Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Date of Birth* Day Month Year Photo*Attach a recent and clear photo of your face.Accepted file types: jpg, jpeg, png, pdf, Max. file size: 2 MB.1. Do you have any experience with meditation? If yes, please tell us more.*2. How did you find out about the retreat with Swaha? If it was through a person, who was it?*3. Have you been to Satsang before? If yes, where and with which Master?*Please watch the videos in this link before answering the question below:4. How did you experience the videos / how did you feel about them?*5. Have you taken part in any groups or therapies for personal growth? If yes, which one(s)?*6. Do you have any allergies or any contagious diseases? If yes, which one(s)?*7. It is important that you know that in the retreats we have groups and meditations which have the purpose of triggering, bringing to the surface and releasing deep emotional layers. Because of this, it is important that we have this background information about you – and that you answer in detail and honestly: Do you have any health issues? Are you now or have you been in the past under psychiatric treatment? Do you have any psychiatric diagnosis? Have you ever been hospitalized for psychiatric reasons?*8. Do you take or have you taken prescription drugs? If yes, which ones and how often?*9. Do you take or have you taken drugs in the last 3 years? If yes, which ones and how often?*10. What are you doing or working with at present?*11. What is most important for you in your life? Mention one or more things.*12. Tell us about something that has happened in your life that made a big impact on you. Maybe something that made a difference in your life choices or that made you reflect on life in a new way.*13. Are you willing to look at yourself in this retreat? Express in some words what this means to you.*14. What do you seek from joining Vasant Swaha’s retreat?*Consent*The personal data and other information supplied, is for the sole purpose of obtaining an overview (background and experiences) of the person who is interested in taking part in the retreat. The personal data and other information supplied, will be sent, exclusively, to the people who are responsible for the bookings and to the caretakers in the retreat, and will be kept securely. At any time, this data can be accessed, corrected or deleted at the participant’s request. I agree with the privacy policy.CAPTCHA