Application Form — Service Period
November 03, 2024November 06, 2024 | Shelburne Falls, Massachusetts, United States
Have you completed a 10-day course with S.N. Goenka or any of his assistant teachers? Select Yes if you are an old student in this tradition
Select Gender Please select your gender

If you do not identify as a male or female, please know that we welcome people of all sexual orientations and gender identities. However, it is important for you to know that meditation centers in this tradition are separated into two distinct sides: one for men and one for women. This separation includes the residential accommodations, the dining rooms, the meditation hall, and the walking areas.

We recognize that you may be non-binary, transgender, or that you may have other reasons that “male” or “female” does not suit you. While either side may feel uncomfortable to you, please choose either "Male" or “Female" to indicate on which side of the campus you would prefer to be accommodated, and then describe your personal situation in the section of the application form that asks, ‘Is there anything you wish to add?’. It is important for us to have this information in advance so that arrangements can be made to best accommodate you. Please note that not every center location has single accommodations, or the capacity to accommodate every requirement. If necessary, we can direct you to another center that may better fit your needs.

Country or Region Please select country or region of residence
By checking the box below, I acknowledge and agree that any and all information provided in this application for acceptance into a Vipassana Meditation course, or otherwise provided by me to the Vipassana organizations, may be used by the Vipassana organizations for their purposes consistent with their Privacy Policies, as amended from time to time.
Click here to download a PDF copy of Dhamma.org Privacy Policy, Disclosures & Consents for non-Long Course applications.
Click the "Next " and "Back" buttons at the bottom of each page to move from one page to the other. Click the "Cancel" button to cancel your application and return to the course schedule.