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Advanced Practitioner Program Application

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Advanced Practitioner Program Application
Advanced Practitioner Program (APP)
Thank you for your interest in Spirit Rock’s Advanced Practitioner Program (APP). APP is intended for senior students of the Dhamma who want to explore the liberation teachings of the Buddha through practice, study, inquiry, and interactive exercises. It is a multi-year program consisting of three retreats and is intended for those who have completed programs like Spirit Rock’s Dedicated Practitioners Program (DPP), Community Dharma Leader Program (CDL), Heavenly Messengers Program (HM), or equivalent. The retreats are: • Emptiness and Liberation, April 23 - May 1, 2016 - Spirit Rock Meditation Center • Nature of Awareness, November 7 - 15, 2016 - Spirit Rock Meditation Center • Radiant Mind, Peaceful Heart, April 21 - 29, 2017 - Yucca Valley, California The purpose of this program is to bring to life the liberating teachings of the Buddha both on retreat and in our daily practice. The first two retreats will focus more on silent, intensive practice than DPP or CDL, but each retreat will include regular interactive and study sessions. The Buddha said that he teaches just suffering and the end of suffering. These retreats will focus on the ending of suffering – Nibbana - and the practices and insights that lead to this ending. The first retreat of the program, Emptiness and Liberation, will be held at Spirit Rock from April 23 - May 1, 2016, taught by Gil Fronsdal, Guy Armstrong, and Sally Armstrong, with Susie Harrington as core program teacher. This retreat is a further development of a senior students retreat on Emptiness previously held at Spirit Rock. The second retreat of the program, Nature of Awareness, will be held at Spirit Rock from November 7- 15, 2016, led by Phillip Moffit, Guy Armstrong, Sally Armstrong, and Adrianne Ross, with Susie Harrington. Awareness is the heart of sentient life, the central faculty that reveals to us all the phenomena of our experience. The third retreat of the program will be held in Yucca Valley, California in April 21 - 29, 2017 and will focus on more of these liberating teachings, but will not be primarily in silence. Joining the teaching team is one of our foremost scholars, Venerable Bhikkhu Bodhi who will share his unparralleled knowledge of the Buddha's teachings and discourses. It will have interactive study and practice sessions throughout the week, like the format used in DPP retreats. In addition, participants commit to maintaining both meditative and daily life practice, working with monthly homework that includes readings, reflections and meditation instructions, ongoing meetings with study/practice partners, and regular conference calls with APP teachers. Depending on the location of students and teachers, monthly or bimonthly groups may be formed. Spirit Rock is excited to offer a program like this to our senior students, and hope that those of you who have done DPP, CDL, or HM will join us. The program will be led by Sally Armstrong and Susie Harrington, and the faculty will include Gil Fronsdal, Phillip Moffitt, Guy Armstrong, and other senior teachers.

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Advanced Practitioner Program Application
Application Overview All applications should be completed electronically. Please do NOT handwrite any portion of this application. All information is confidential to the teaching and management teams of the APP program. If you have any questions, please contact our APP Administrative Coordinator at APP1@spiritrock.org Submission Process Please submit your application electronically including a digital photo to APP1@spiritrock.org or via US Mail to APP Program c/o Spirit Rock Meditation Center, PO Box 169, Woodacre, CA 94973 Timeline September 30, 2015 – completed applications including a digital photo and scholarship requests must be received by this date. Please note that incomplete applications without an attached digital photo cannot be processed. December 1, 2015 – Notification of your status will be sent no later than this date via email. Today’s Date First Name Last Name Date of Birth Mobile Phone Number Additional Phone Number Street Address City, State, Zip Code E-Mail Address Name of APP Mentor Teacher* * A mentoring teacher provides approximately 6-12 interviews during the course of the program. If you do not already have a mentoring teacher, we can support you in your process of finding one. You do not need a mentoring teacher to apply for the program, but having one is supportive of your application. Please be sure to get prior approval from your mentoring teacher prior to listing them on this form.

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Advanced Practitioner Program Application
A) Demographic Information 1. How do you self-identify your racial and ethnic heritage or background? 2. How do you self-identify your sexual orientation? 3. How do you self-identify your gender identity? 4. Do you identify as a person with physical limitations? Yes No 5. If yes, please describe anything you might need to ensure your full participation, if accepted. 6. What is your livelihood/occupation or are you retired? B) Dharma and Practice History 1. When did you begin your dharma practice? 2. Whom do you currently regard as your primary vipassana or Buddhist teacher(s)? 3. Who have been your most important teachers? 4. Prerequisite for APP is completion of the Dedicated Practitioner Program (DPP), Community Dharma Leader Program (CDL), Integrated Study and Practice Program (ISPP) or equivalent. How do you meet the prerequisite for APP at this time?

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Advanced Practitioner Program Application
5. Please use this page (or attach a sheet) to list the silent, residential vipassana and metta retreats you have attended. Keep in mind that the prerequisite for APP is 50 nights of silent, vipassana, and/or metta residential retreats.
Month/Year Location Teachers
Number of Nights 6. What is the total number of retreat nights from the list above?

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Advanced Practitioner Program Application
C) Personal Information Intensive retreat can be physically and psychologically challenging. To support retreatants in those rare cases when difficulties do arise, having information regarding the following questions will help teachers respond to the situation more effectively. Your answers to these questions will be read only by teachers and will be destroyed after the program. We encourage your candor in responding. If you would like to discuss any particular question with a teacher rather than write your response, please indicate that and we'll arrange for a private meeting. 1. Do you have any condition or history of physical illness or physical limitations that may interfere with or might be aggravated by sitting or walking practice? 2. What kinds of psychotherapy, if any, have you or are you engaged in? Have you ever had or been treated for a psychological condition such as depression, eating disorder, drug/alcohol addiction, anxiety disorder, psychosis, schizophrenia, mania or any other psychological condition? If yes, please specify condition(s) and date(s): 3. Are you currently taking medication for any physical or psychological conditions? If yes, please specify the condition(s) and list the medications and dosage.

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Advanced Practitioner Program Application
4. If you are taking medications for physical conditions, do they affect your psychological functioning? If yes, please describe the effect(s). 5. Have you experienced any significant emotional, psychological or spiritual difficulty in your life (that affected your ability to function)? If so, please briefly describe it and when it occurred. Is it still occurring now? 6. Have you ever seriously contemplated or attempted to take your life? Yes No 7. If yes, please state when. 8. Have you ever experienced any trauma that has been emotionally difficult for you (e.g. accidents, in military service, PTSD, childhood abuse, etc.)? Yes No If yes, please describe.

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Advanced Practitioner Program Application
9. How does the practice of meditation, silence and retreat affect all of the above conditions? 10. Are there present conditions in your life which may be placing you under stress, or which might make meditation difficult for you at this time (e.g. fasting, recent loss of a loved one, substance abuse/withdrawal, relationship ending)? 11. What is your current family and personal relationship situation? Include any other details about your current life situation that would be helpful for us to know. 12. Please describe why you would like to be in the Advanced Practitioner Program. What motivates you to participate in APP at this time?

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Advanced Practitioner Program Application
13. Please note any other information you would like us to know. 14. Please seriously consider this question: Is there any reason you would not be able to fulfill your commitment to participate completely in this program? D) Financial Assistance Do you anticipate needing scholarship funds for APP? Yes No If yes, please describe the financial need and your current financial circumstances including your annual household income and the number of persons in your household. Please provide an honest and accurate assessment of your financial situation so we can consider the total amount of resources we need to maximize everyone’s participation. Special consideration is given to individuals who self-identify as being a person of color.

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Advanced Practitioner Program Application
E) Program Cost Structure Program Attributes Listed below is the sliding scale ($9,000 – $4,150) for APP tuition which includes: • Accommodations and meals at all three residential retreats • All handouts and program materials • Access to social media and online community building groups The tuition costs do NOT include: • Teacher and retreat staff support (dana) • Transportation costs to/from your home to the retreat centers • Mentor teacher support (dana) for individual meetings with your mentor teacher in your area Sliding Scale Tuition Please consider the amount you would be able to afford in order to participate in APP. We ask you to select the highest possible level of tuition that meets your needs, as your generosity allows for those with lesser means to attend. Please note that the scholarship funds are limited for this and every Spirit Rock program. Regrettably we cannot guarantee the full amount of support requested. • $9,000 Supporter Rate with Single Room Guarantee* • $8,300 Sliding Scale 3 • $6,225 Sliding Scale 2 $4,150 Sliding Scale 1 - Base Rate • $3,225 Scholarship Rate 1 • $2,300 Scholarship Rate 2 ➢ Please enter the amount you will be able to afford in the text box below. Please note that scholarships are limited and we may not have enough funds for all applicants. Upon acceptance to the program, you will be asked to pay a minimum $500 non-refundable deposit. The remainder of the balance may be divided into three credit card payments over six months or into 12 monthly direct debit payments from a US Checking account over the course of one year. * Single Room Guarantee is only applicable for the two Spirit Rock retreats. We are not able to guarantee a single room @ Yucca Valley.

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Advanced Practitioner Program Application
F) Cancellation Fees Participating in the APP program will require your commitment of both time and financial resources. Because this program is a progressive sequence of three retreats and other activities over a two-year period, you are committing to attend all three retreats and paying for the entire program. If you need to cancel for any reason, the following fee structure will apply. • $500 Prior to March 31, 2016 – this is the non-refundable deposit amount • $1950 April 1, 2016 – October 23, 2016 • $2,820 October 24, 2016 – March 17, 2017 • $4,150 March 18, 2017 – end of program I have read and understand the applicable cancellation fees for the APP program. Confirmed * Please note that scholarship recipients will pay cancellation fees based on their payment rate and cancellation timing. G) Final Agreement By typing my name in the space below, I agree, to the best of my ability to participate fully in the Advanced Practitioner Program (APP) if I am accepted. This includes attending all scheduled meetings; completing all readings, practices and reflections; developing and maintaining a relationship with my mentors and teachers; being available for the designated interviews and meetings; and attending all three residential retreats of the program as well as all financial obligations outlined in this application. Name Today’s Date
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