Month Long Mindful Giving & Receiving Retreat

Application Form

Please complete the application form in its entirety with as much relevant detail as possible.

Once your interview is complete and your application approved, you will be sent a link for payment.

PLEASE NOTE: WE ARE ACCEPTING APPLICATIONS FOR THE FOLLOWING MONTHS ONLY. If the month you prefer says "FULL" then unfortunately we are over subscribed for that month. Please consider another possibility from the drop down menu below. Retreat Modules are 28 days in length - retreat attendees begin and end together, beginning on the first of the month and ending on the 28th of the month.
Name *
Name
Birth Date *
Birth Date
Address *
Address
Phone *
Phone
Emergency Contact Phone *
Emergency Contact Phone
Emergency Departure Address *
Emergency Departure Address
Should an emergency arise (fires/floods/etc.), or there has been a violation of agreements, you may be required to depart within 24-48 hrs to the address listed here
I have sufficient funds to support myself if I am required to leave the retreat? *
Video Interview Contact Information *
Video Interview Contact Information
Once we receive your application we will set up a Video interview. Please let us know if Skype; WhatsApp Video or FaceTime works best and provide contact information.
Briefly describe your motivation for applying for this month long mindfulness retreat and what you hope to achieve during your stay at Bodhi Khaya Retreat
I would like to apply for a scholarship to attend this retreat *
We intend to make this retreat accessible to everyone. The base fare of R7000 for this retreat is to cover the minimum costs of hosting you for a month. Should you be unable to afford this please check "YES" and continue on and complete the scholarship motivation below
If you are unable to afford the basic cost of this retreat, please describe your situation and provide a motivation for requesting a scholarship
Education Level *
Check the one
Briefly list and describe your work experience
I have the following basic rural living skills *
Please check all that apply
Briefly describe the types of therapies you have engaged in.
List your interests, hobbies, and pastimes
List any similar retreats or volunteer experience you have and include length and dates
Potential Length of Commitment *
Check all that apply
Enter "none" if you have no issues
Describe your prescriptions and frequency of use. Please not that Bodhi Khaya Retreat is in a rural setting so please bring sufficient medications for your stay with us.
Please let us know if there is anything we can do to make your stay with us more comfortable
Let us know if you suffer from any allergies cause by food, the natural environment, animals, or chemicals
Bodhi Khaya Retreat is within a Nature Conservancy where wildlife is abundant. Please let us know if you have any phobias around snakes, spiders, insects, wildlife etc.
Special Diet *
The retreat centre at Bodhi Khaya is strictly vegetarian.
Describe any particular dietary needs or concerns you may have
If I am selected, I agree to not enter a relationship or engage in sexual relations during my month long retreat *
Please note that the use of recreational drugs and/or alcohol is not permitted.
List any family members who are dependant upon you while you are away.
List any obligations which may require your attention while volunteering at Bodhi Khaya
Valid Drivers License *
Check all that apply
Transportation to Bodhi Khaya Retreat *
Email Newsletter *
Terms and Conditions *

Once your application is received a video interview date will be set up with you. If all goes well we will allocate very comfortable volunteer accommodations for your 28 day module. Please note you may share a room with another volunteer of the same gender.