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Home
About
Newcomers
Weekly Mindfulness Topic
Calendar
Resources
Making-Visible
Donate
2022 OHMC aNNUAL RETREAt FORM
Name
*
First Name
Last Name
Email
*
Phone
(###)
###
####
Do you identify as a Person of Color or as Multiracial?
*
The Open Heart Mindfulness Community seeks to foster understanding and compassion by providing vibrant and generous opportunities to practice mindfulness within a diverse community in the Plum Village tradition, founded by Zen master Thich Nhat Hanh. We recognize that in supporting racial and social justice equity within our sangha and throughout the mahasangha, we support the work of transformation individually and collectively. Accordingly, to balance the demographics of those attending the retreat and to create an environment that supports all, we request that you check the box below regarding your race/ethnicity. Our goal is to support participation in the upcoming retreat with a minimum of 30 % self-identified BIPOC (Black, Indigenous and People of Color), BAME (Black Asian or Minority Ethnic), and Global Majority. We acknowledge the work of communities within the Plum Village tradition who have modeled this approach.
Yes
No
Our intention is to remove as many barriers to participation in the online retreat as possible. Please let us know how we can best support your needs during this online retreat in order to make it safe, welcoming and comfortable for you.
Would you like to be included in an affinity dharma sharing group during this retreat? If so, which group would you like to be in:
*We define disability broadly to include people with physical impairments, people who belong to a sensory minority, people with emotional disabilities, people with cognitive challenges, and those with chronic/severe illness. We understand the experience of disability to occur within any and all walks of life, with deeply felt connections to all communities impacted by the medicalization of their bodies, including trans, gender variant and intersex people, and others whose bodies do not conform to our culture(s)' notions of "normal" or "functional." (sourced from https://www.sinsinvalid.org/mission)
Select one
BIPOC / BAME, Global Majority
LGBTQIA+
Persons with Disabilities (*see above for definitaion)
White
Other
If you plan on using your phone through Zoom's dial-in, please rename yourself when you arrive and provide the phone number you will be dialing in from here:
How long have you practiced mindfulness / meditation?
*
Select one
0-1 years
2-5 years
6-10 years
11+ years
How long have you practiced mindfulness / meditation in the Plum Village tradition?
*
Select one
0-1 years
2-5 years
6-10 years
11+ years
How did you hear about this retreat?
*
Select one
OHMC social media
OHMC website
OHMC email
Circle Yoga
ARISE
Still Water
Washington Mindfulness Community
Valerie Brown
Other
Thank you! We look forward to practicing with you on April 9th.
