REGISTER

Indonesian Version

PERIOD 期限
Period of Practice Applied for 入住日期
From 开始*
DD slash MM slash YYYY

Please apply minimum 7 days from today. From date is the date you plan to arrive in the Centre. The gate is open from 6 AM to 6 PM. If you cannot make it before the gate closing time, please select the day after.
To 离开*
DD slash MM slash YYYY

To date is the date you are planning to leave the Monastery. If you intend to stay longer than your approved date, you will need to seek permission from the Centre.
PERSONAL PARTICULARS 个人资料
Name (as in NRIC/Passport) 姓名*

Please provide your full name and not your NRIC/ passport number as it will result in your application being rejected.
Date of Birth 出生日期*
DD slash MM slash YYYY
Gender 性别*
- Male 男
- Female 女
Telephone No. 电话号码*
Email Address 电邮*
Current Address 当前地址*
Address 地址 City 城市 State / Province 省 ZIP / Postal Code 邮政编码 Country 国家
Preferred Language 主要⸼用语文*
Nationality 国籍*
NRIC No. 居民证号码*
PAMC Member 新加坡帕奥禅修中心会员*
- Yes 是 Ya
- No 否 Tidak
Passport No. 护照号码*
Passport Expiry 护照㚱效日期*
DD slash MM slash YYYY
Visa Expiry 签证㚱效日期*
DD slash MM slash YYYY
Photo ( Format : JPG,PNG,BMP )*
Maximum Upload Size : 4MB. Please DO NOT upload the photo of your passport or full body photo as this may cause your application to be rejected. Please upload passport-size photo showing your face clearly.
Have you been ordained?*
FOR AN ORDAINED PERSON 出家人
Ordained Name 法号*
Preceptor Name 戒师法号*
Ordination Date 出家年份*
DD slash MM slash YYYY
Position / Posisi*
- Bhikku/Bhikṣu 比丘
- Sāmaṇera 沙马内拉
- Bhikṣuṇī 比丘尼
- Sayalay 出家戒尼
FOR A LAY PERSON 在家人
Religion 宗教信仰*
Occupation 职业*
If Buddhist, please specify 如佛教徒，请填写
- 3 Refuges 归依ἃ法僧
Buddhist Only
- 8 Precepts 守持八
- 5 Precepts 五戒
Please select where appropriate 请圈适用者. All Yogis are expected to keep at least 8 precepts while staying at the Centre.
CONTACT PERSON 联络人
Emergency Contact Person 紧急联络人姓名*
Relationship 关系*
Telephone No. 电话号码*
Name of Referee 推介人姓名*
Relationship 关系*
Telephone No. 电话号码*
MEDITATION EXPERIENCE 禅修经验
Type of meditation practice 禅修业处/方法
Meditation Teacher(s) 禅师名字
Have you practised at a Pa-Auk centre in the past? 您是否有过在任何帕奥中心学习禅修的经验?
- Yes 是
- No 否
(For a Lay Person only) If so, please give a brief description of your meditation experience (只限在家人填写) 如有，请简述您的禅修经验*
HEALTH CONDITION 健康状况
Do you have any significant physical health ailments or conditions (e.g. hypertension, diabetes, cancer and/or contagious diseases) that may affect your/others capacity to practice ? 您是否有任何导农影响修行的特殊健康状况或疾病 ( 例如：高血压ˣ糖尿病ˣ癌症或/以及任何传染疾病等 )*
- Yes 是
- No 否
If so, please give details of your present condition / medication, the condition's history and treatments. 如有，请注明您现在的健康状况 / 服用药物ˣ病⎚及治疗状况*
Do you currently have, or in the past, had any mental health conditions (e.g. depression, panic attacks, hysteria, and/or fits/epilepsy) ? 您是否患有任何精神方面的疾病，如抑郁症、焦虑症ˣ歇㕗⸽慴或/以及癫痫症等？*
- Yes 是
- No 否
If so, please give details of your present condition / medication, the condition's history and treatments. 如有，请注明您现在的健康状况 / 服用药物ˣ病⎚及治疗状况.*
Do you have any addiction to cigarettes, alcohol, recreational drugs or any other intoxicants? 您是否有烟、酒瘾？或吸食任何毒品的习惯？*
- Yes 是
- No 否
If so, please give details of past and present usage, types, addictions, treatments, etc 如有，请注明您过去以及现在对烟ˣ酒以及毒品的用量ˣ种类ˣᶲ瘾程度ˣ治疗状况等*
5.4 Do you have any homo-sexual tendencies ? 您是否有ྠ性恋倾向？*
- Yes 是
- No 否
APPLICATION & APPROVAL
Every yogi who wants to settle down and practiced meditation in Tawya Rempang must fill out and send back "The application form to settle and practice of meditation" to Tawya Rempang committee. 所有有意入住瑞邦禅修林的禅修者必须填妥此“入住禅修”申请表格并呈交予瑞邦禅修林入住⥼员会提出申请

Permission is given depends on your agreement to accept and comply with all applicable regulations in Tawya Rempang, with a sign on all of these statements 批准入住申请的条件包括禅修者签署ᶳ列之声明承客并⎴意接受及遵守瑞邦禅修林的条规炷随附炸

The committee can approve settling period, from several days to one month, depending on conditions. For yogis who want to live longer, application for extension of residence permit will be reviewed, with each renewal period applies for a maximum of one month. 入住ጤ 员会将视个别情况批准数日军ᶵ超过一个㚰的入住申请ˤ如禅修者㚱意继续留住，延期申请将由入住⥼员会慵㕘评估，每次批准期限也将不超过一个㚰

If the application is approved, the yogi is allowed to settle and practice in a meditation center will be given accommodation, breakfast, lunch and beverages. All other personal needs (such as medication / equipment and personal needs, transportation and visa) yogi bear. 申请批准⎶，禅修林允许禅修者入住禅修并使用指定寮㇧ˣ食用禅修林提供的两顿餐食以及如法饮料ˤ禅修者℞他的需求炷如医疗/牙科保健、交通及签证等炸将由禅修者自己承担ˤ禅修者请确保拥㚱足够支付这ṃ㇨需品的经费

Yogi must receive a letter of approval from the committee before coming to the meditation center. 禅修者必须获得申请批准⎶才能前住禅修林入住
Please tick in the box to indicate that you have read and understood the Application & Approval process. 如您已阅宣以及了解以ᶲ 主要条规，请于边的格子内打勾*
- I have read and understood
Remarks 备注
DECLARATION & UNDERTAKING 声明及承客
I hereby declare that all the information provided above is true.

I undertake to refrain from using mobile phones/devices on the Hermitage’s compound as these can cause distractions and hindrances to meditation.

I have read the Rules & Regulations and undertake to abide by them. I shall respect and follow the Resident Teacher's instructions as well as the Hermitage Management’s advice where applicable. I undertake not to cause any disturbance. Failure to do so may cause the Management to rescind the permission granted for me to stay at the Hermitage. Any costs incurred for me to leave will be my responsibility.

I shall practise according to the system of meditation taught at Pa-Auk Tawya, as based upon instructions found in the Pali Buddhist texts, and attend regular interviews with the Teacher.

(For a non-Indonesian only): I hold a valid visa. I undertake not to participate in any way whatsoever in the political affairs of Indonesia, and that I will remain at the Hermitage for the entire duration of my visa.

I shall not hold the Hermitage and its Management liable for any mishap or injury (physical or mental), and damages to or loss of personal property that may occur during my stay and practice at the Hermitage.
Acceptance*
- I agree to the Terms and Conditions
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Please fill your full name and today date*
Name Date
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Today Date*
DD slash MM slash YYYY
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About Meditation

The meditation taught at Pa-Auk Tawya is based on the instructions by The Buddha as found in the Tipiṭaka (the Pāli Canon) and its commentaries.

In brief, the main practice is to begin with Samatha (tranquility) meditation, which is to develop absorption concentration, also called jhāna. A yogi (meditator) is free to choose any of the forty Samatha subjects as taught by The Buddha.

Contact Us

Pa-Auk Tawya Vipassana Dhura Hermitage
(Approx 8km from 4th bridge (Barelang)
turn right and go up, follow the sign)
+6281317799000 (Ibu Diana)
+6590810075 (Ibu Susi Wijaya)
FAQs
contact@pa-auktawyabatam.com

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PERIOD 期限

PERSONAL PARTICULARS 个人资料

FOR AN ORDAINED PERSON 出家人

FOR A LAY PERSON 在家人

CONTACT PERSON 联络人

MEDITATION EXPERIENCE 禅修经验

HEALTH CONDITION 健康状况

APPLICATION & APPROVAL

DECLARATION & UNDERTAKING 声明及承客

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