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Course and Accommodation Booking Form

To book for couses or to stay at Kopan, fill out this form and click Preview to proceed. You will be given the option of paying a deposit now, or paying later. Please note that a wheat/dairy free diet is not possible.

The registration for the one month course starts from 1st July. Please do not register earlier, as your registration will not be accepted. Please make sure to send the required deposit with your registration for the November course.

Your Personal Details

(R) = Required information
Name
(R) 		Address
(R)
City
(R) 		State
Postal/Zip Code
Country
(R)
Phone

Fax
E mail
(R) 		Age
(R)
Gender (R) Male Female Nationality
(R)
 
Your Dharma experience
Are you new to Buddhism(R) Yes No
Have you attended Buddhist teachings before? (R) Yes No
Are you a regular visitor or member at a Buddhist Center? (R) Yes No
 

Course or Visit Booking Request

Short Course - Starting Date

1 Month November Course
I Plan to atend the one week retreat following the November course.

Private stay or Retreat
(This is a request only. Acceptance depends on availablilty of rooms - Please do not send deposit)

Expected arrival Date
(R)

Expected Departure Date
(R)
   

Preferred Accommodation (R)
Please choose from the following options
During the course all rooms are on share basis

****Accommodation for November course*****
Only dormitory and tent accommodation is now available for the November course

GH fully booked for November course
NGH Fully booked for November course
THK Fully booked for November course
TH fully booked for November course
Small Single (GH) - private bathroom
Small Single - private bathroom (new)
Small Single - shared bathroom (new)
De luxe double room - priv. bath - sitting room - AC - share basis   
De luxe double room - priv. bath - AC - share basis

Standard 3 bed room - private bath - share basis
Simple double shared facilities - share basic
Dormitory
Tent

This option is not available for the One Month course.

Single Use - De luxe double room - att. bath - sitting room - AC
Single Use - De luxe double room - att. bath - AC

In case your choice of accommodation is booked out, please give a second and third choice in the comment box below.
Click here for more information on the cost of your Accomodation

Paying Your Deposit - Please choose one option (R)
A deposit is required of $40 US for short courses and $75 US for the One Month course.
 
I will pay by Credit Card I will send a Draft of Personal Check

After submitting this form you will be able to make a secure on-line payment through the FPMT credit card facility.

Please contact me about the best way for me to pay

Total Deposit in US$ (R)

You will receive an e-mail confirmation outlining your payment details. Please print this e-mail and post it along with your draft or check to the below address. Please make payable to"FPMT inc" in US dollars. Personal checks can only be sent by US residents.

FPMT Inc
1632 SE 11th Avenue,
Portland OR 97214-4702
USA
Phone 1 + 503.808.1588
fax 1+ 503.808.1589
 

Comments

I have read and understood the conditions of attendance and agree to abide by the rules and discipline as set out.
 


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