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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

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)
Attended Buddhist teachings before? (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

* NOTE: Only dormitory accommodation and tent accommodation is available for the November Course

Single - private bath
Shared 3 bed room - private bath
Simple single shared facilities
Simple double shared facilities
Dormitory
 

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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You will be able to preview and confirm your entry before submitting