enroll

Booking for a retreat (English Program)

Please fill out the form only when you are intend to join the program.
Booking confirmation will return to you via email.
Please keep us updated in any changes on your booking at booking@dipabhavan.org in order to make the best use of spaces and food supplies.

RETREAT BOOKING FORM

* Indicates required field

The Meditation retreat I would like to enroll :

Select One *

First name:

Untitled *

Last name:

Untitled *

Passport Number:

Untitled *

Sex:

Choose One *

Female Male

Age :

Select One *

Home Country:

Untitled *

Current Address:

Comment *

Occupation:

Untitled *

Email Address:

Untitled *

Re-type Email Address:

Untitled *

Comment/Question:

Comment *

How do you get to know Dipabhavan:

Untitled *

Submit

096-993-6955

ร่วมสนับสนุนกิจกรรมมูลนิธิทีปภาวัน ได้ที่ธนาคารกรุงไทย สาขาละไม บัญชีเลขที่ 756-0-05982-1