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Required fields are marked in red.
(This retreat is already booked out and your application will be placed on a waiting list.)
Gender:
Male
Female
First Name:
Last Name:
E-mail:
You must complete at least one entry of either Home, Work or Mobile phone.
Home Phone No:
Work Phone No:
Mobile Phone No:
How are you travelling to this retreat?
Car
Rail
Other
Emergency Contact Name:
Emergency Contact Phone No:
Your Street Address:
Suburb:
State:
NSW
VIC
QLD
SA
TAS
WA
NT
Postcode:
Is this your first retreat with the Brahma Kumaris?
Yes
No
How did you find out about this retreat?
Word of mouth
Email
Website
Brochure/Flyer
Meditation Centre
Other
What industry do you work in?
Health
IT
Environmental
Business
Sport & Recreation
Media
Education - Teacher
Student
The Arts
Parent/Guardian/Householder
Marketing
Administration
Engineering
Finance
Science
Psychology
Natural Therapies
Child Care
Travel/Tourism
Retired
Transport
Media
Social Work
Trade Profession
Retail
Hospitality
Sales
Solicitor
Real Estate
Music
Catholic Priest
Manager
Name of person you wish to share
room with, if appropriate:
(ALL PERSONS MUST BE BOOKED INTO RETREAT ON SEPARATE FORM.)
Do you have any medical condition which
is important for us to know e.g. diabetes, asthma?
Yes
No
If yes write in comments box to the right.
Are you receiving treatment or taking any medication for a psychological disorder?
Yes
No
Do you have any special dietary requirements?
Yes
No
If yes write in comments box to the right.
  
Brahma Kumaris Retreat Centre Locations
Frankston South, Victoria
Inner Space, Wilton, New South Wales
Retreat calendar and bookings