Wellness Policy Update
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Residency Application
Karmê Chöling Residency Application
Name
*
Email
*
Are you vaccinated against COVID-19?
*
Yes
No
Partially
KCL currently requires that all residents be fully vaccinated against COVID-19. Please contact the KCL COVID Officer at personnel@karmecholing.org if you have any questions about this policy.
Primary Phone number
*
Secondary Phone
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
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Armenia
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Australia
Austria
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Bonaire, Sint Eustatius and Saba
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China
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Congo, Republic of the
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Curaçao
Cyprus
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Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
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Guinea
Guinea-Bissau
Guyana
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Indonesia
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Iraq
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Kiribati
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Mali
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Nigeria
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Panama
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Pitcairn
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Romania
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Rwanda
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Saint Lucia
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Samoa
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Slovenia
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Sweden
Switzerland
Syria
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Tajikistan
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Thailand
Timor-Leste
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Tokelau
Tonga
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Uganda
Ukraine
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Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
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Country
Preferred method of contact
*
Primary phone
Secondary phone
Email
Karmê Chöling Information
Have you ever been to Karmê Chöling?
*
Yes
No
Please let us know when and for what you were previously at Karmê Chöling.
*
When would you like to move to Karmê Chöling?
*
How long would you plan to live at Karmê Chöling?
*
(minimum stay for residency is 3 months)
Goals for Residency
*
Please share your reason(s) for wanting to live at Karmê Chöling.
Your age
20 or younger
21-35
36-50
51-65
65+
What are your preferred pronouns?
What members of your household would be living with you?
*
A partner/spouse
1 child
Multiple children
furry friend/pet (only possible in special circumstances)
N/A - Free agent/Only me
Your household
*
List all members of your household who would be living with you at Karmê Chöling. Please include name, age (for children), and relationship.
Practice and Training Information
What was the last program you participated in on your Shambhala Path?
*
When and where.
Do you have a meditation practice?
*
Yes
No
Please describe your practice, how long you have been meditating and what your daily/weekly time of practice is.
*
Have you completed any Shambhala Training Levels?
*
Yes
No
Which is the last level that you completed?
Are you affiliated with a Shambhala Center?
*
Yes
No
Which Shambhala Center are you affiliated with?
*
Please describe your center activities or other dharma work, including if you are an MI, AD, SG or a member of the Kasung
*
References
We require two references: 1- Meditation instructor (or teacher within Shambhala) 2- Personal reference (not a family member)
Meditation instructor or teacher within Shambhala
Name, phone, email, relationship to you
Personal reference (not a family member)
Name, phone, email, relationship to you
Housing Arrangements and Personal Information
Requested Housing Arrangement (1 person, per month)
*
A Security Deposit is required. For a residency of greater than 6-months, the deposit is equivalent to one month’s stay; for a residency of less than 6-months, the deposit is equivalent to half a month’s stay.
Dorm Bed - $750
Standard Room - $1,100
Premium Room - $1,400
Food (per month and required)
*
1 person - $400
Additional person - $400
Additional child (under 14) - $320
Additional Housing Requests (per month)
Additional Premium Room - $600
Additional Standard Room - $500
Additional Economy Room - $400
Additional Private or Semi-Private Office - $300-500
Shared/Floating Office Space - $100
Roommate - $100 (adult)
Child(ren) - free
Can you demonstrate a steady source of income or savings sufficient to cover the cost of your residency for at least 3 months?
*
Yes
No
Are you employed?
*
Full-time
Part-time
Student
Retired
No
Will you be working remotely while you live here?
*
Yes, for 100% of the time
No
Who is your employer?
What is your occupation?
Please share anything else you'd like us to know about yourself:
Background check
*
I agree to a standard background check.
All residents will have a routine background check as part of Shambhala's Child Protection Policy. The results will only be seen by HR. If your application is approved, do you agree to having a routine background check as the last step before residency approval?
COVID Safety Agreement
*
Please read online at https://www.karmecholing.org/wp-content/uploads/2020/06/COVID-Safety-Requirements-6-14-20.pdf
I have read and agree to this.
Code of Conduct and Community Agreements
*
Please read online at https://www.karmecholing.org/care-and-conduct-policies
I have read and agree to this.
Do you have any chronic illnesses or health concerns?
*
Yes
No
If yes, please describe:
What kind of diet do you have?
*
Vegan
Vegetarian
Omnivore
Gluten-free
Other
Do you have any dietary concerns or special dietary needs?
Please include food allergies.
Do you have any mental or physical health concerns that you would like to share with us? How can Karmê Chöling support you in this regard? How are you supporting yourself?
*
Thank You
Thank you for your time in completing this Residency Application. We look forward to speaking with you soon!
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