Shambhala Congress 2005 Registration

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Shambhala Congress

Shambhala Congress 2005
Halifax, Nova Scotia
February 13-17, 2005

Personal Information

First Name	Last Name

Address	City	Province/State

Country	Postal Code	Birth Date

Home Phone		Work Phone		Cell Phone

Email	Gender
	Male Female
Buddhist Practice	Highest Shambhala Training Level completed

Have you attended Kalapa Assembly?

Yes No

Shambhala Center Affiliation

Are you a member of your local center?	Yes No
Which center?
Position you hold at that center, if any:
If you will be representing an entity or center at the congress, which one(s)? (Please check all that apply. Our apologies if your group is not listed.)	Council of Acharyas Council of Warriors Dorje Kasung Command Group European Donor Group Maitri Council Mandala Governing Council Nalanda Translation Committee Sangyum Shambhala Congress Staff Shambhala Europe Staff Shambhala International Board of Directors Shambhala International Staff Shambhala Trust Vajravairochana Translation Committee Working Group Chair Other: Center:

Language Fluency
Primary Language:	Do you need translation from English into your native language?
	Yes No

Lodging Arrangements

Where do you plan to stay during the Congress?
If staying with a sangha member, with whom?
Would you like assistance in finding a place to stay with a sangha member?	Yes No
If you live in or near Halifax, do you have room for a guest during the program?

Pema Karpo

Will you be attending the Pema Karpo program?	Yes No
If Yes, the discounted charge of $60 for the Pema Karpo program will be added to your Congress payment. After you have finished registering for the Congress and paying for both programs, please go to the Pema Karpo registration page.

Payment

How do you plan to pay for the Congress?