IMC - USA Course Application Form - International Meditation Center

Due to the uncertainty surrounding the current pandemic, we ask you to please contact us

before submitting a registration form.

Please first read our Course Guidelines and choose a course date before you complete this application form.

Please note that this application form is for IMC - USA only, in Westminster, Maryland.

NB: If you do not hear from us within three days of applying, please call 410-346-7889 and leave a message.

Fields marked with * are required.

IMC Course Application Form

I wish to attend the Meditation Course to be held from: *

Last Name *

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Date of Birth *

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Male

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1. Have you attended courses in the Sayagyi U Ba Khin tradition before?

Yes

If yes, when and where was your most recent course?

2. Are you currently practicing any other techniques of meditation?

Yes

If yes, for how long have you been practicing them?

3. Are you in good physical and mental health? *

Yes

If no, please give details on your condition. If yes, enter N/A in this box. *

4. Are you currently under a doctor's care for any condition, medical or otherwise? *

Yes

If yes, please describe, including the medications you are taking. If no, enter N/A in this box. *

5. Do you suffer from any serious food allergies? *

Yes

If yes, please provide details. If no, enter N/A in this box. *

6. How did you learn about this Center and the meditation course?

7. Anything you would like to bring to our attention?

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