Mindfulness of Breathing (Anapanasati) Retreat Application — Buddhist Study and Practice with Rachael O'Brien

Mindfulness of Breathing Retreat 2025/26

Application for Admission

Please note: Only Rachael O’Brien will review this application, and all responses will be confidential unless there is a retreat-related emergency. Prior to filling out this application, please be sure that you have read all of the retreat policies and details, including the “Important -Special Retreat Rules” section, on the TWIM Network website.

Name

First Name

Last Name

(Correspondence regarding the retreat will occur via email)

Telephone Number

Country

(###)

###

####

Spiritual Practice Method

Please describe in detail your current spiritual practice and all previous spiritual practices.

Meditation Practice

How often do you meditate and how long is each sitting?

Previous Retreat Experience

Please list all previous retreats that you have completed. Please be sure to include the name of the teacher, the place of the retreat (if online, state "online"), and the method of practice. Please also include the length of the retreat(s) and the year(s) when the retreat(s) took place.

Physical Health Conditions

Please describe any current major physical health issues, and list any current medications that you are taking.

Mental Health Conditions

Please describe any current and/or previous mental health diagnosis, and list any mental health medications that you are currently taking or have taken in the past.

Emergency Contact Person

Please provide the name of an emergency contact person and state their relationship to you.

Emergency Contact Telephone

Country

(###)

###

####

Mindfulness of Breathing Retreat 2025/26

Application for Admission

TheNobleSearch.com