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Donation Information
Thank you for taking the time to fill out your information.
What program would you like to designate your donation to?
*
General Donations
Sleeping Lodge Fund
Staff Dana
Meal Dana
Special-Needs Housing Fund
General Scholarship Fund
People of Color Scholarship Fund
Young Adults Scholarship Fund (Ages 18 - 35)
Nuns Fund
Please tell us where you'd like this donation to be put towards
For which retreat are you offering your staff dana?
Any (No preference)
Nov 01 - Nov 07 with DaeJa Napier
Nov 08 - Nov 11 with Tim Geil
Nov 22 - Nov 24 with Keri Pederson
Dec 06 - Dec 08 at Volunteer Work Weekend
Dec 29 - Jan 05 with Santikaro
Jan 24 - Jan 31 with Kamala Masters
Jan 31 - Feb 03 with Tim Geil
Feb 07 - Feb 14 with Andrea Fella and Diana Clark, Assisting Teacher
Feb 21 - Mar 20 with Leigh Brasington and Mary Aubry
Mar 27 - Apr 03 with Alexis Santos
Apr 03 - Apr 09 with Murray Kennedy and Patsy Boyer
Apr 17 - Apr 22 with Tina Rasmussen
Apr 24 - Apr 27 with DaeJa Napier
May 01 - May 06 with Keri Pederson and Tuere Sala, Assistant Teacher
May 15 - May 22 with Santikaro
May 22 - May 28 with Ayya Medhanandi Bhikkhuni
May 29 - Jun 05 with Mark Nunberg and Shelly Graf, Assistant Teacher
Jun 05 - Jun 08 with Orgyen Chowang Rinpoche
Jun 12 - Jun 25 with Heather Sundberg and Leigh Brasington
Jun 26 - Jul 05 with Kamala Masters and Steve Armstrong
For which retreat are you offering your meal dana?
Any (No preference)
Nov 01 - Nov 07 with DaeJa Napier
Nov 08 - Nov 11 with Tim Geil
Nov 22 - Nov 24 with Keri Pederson
Dec 06 - Dec 08 at Volunteer Work Weekend
Dec 29 - Jan 05 with Santikaro
Jan 24 - Jan 31 with Kamala Masters
Jan 31 - Feb 03 with Tim Geil
Feb 07 - Feb 14 with Andrea Fella and Diana Clark, Assisting Teacher
Feb 21 - Mar 20 with Leigh Brasington and Mary Aubry
Mar 27 - Apr 03 with Alexis Santos
Apr 03 - Apr 09 with Murray Kennedy and Patsy Boyer
Apr 17 - Apr 22 with Tina Rasmussen
Apr 24 - Apr 27 with DaeJa Napier
May 01 - May 06 with Keri Pederson and Tuere Sala, Assistant Teacher
May 15 - May 22 with Santikaro
May 22 - May 28 with Ayya Medhanandi Bhikkhuni
May 29 - Jun 05 with Mark Nunberg and Shelly Graf, Assistant Teacher
Jun 05 - Jun 08 with Orgyen Chowang Rinpoche
Jun 12 - Jun 25 with Heather Sundberg and Leigh Brasington
Jun 26 - Jul 05 with Kamala Masters and Steve Armstrong
Are you flexible as to the date on which your meal dana is offered?
*
Yes
No
What specific date are you requesting?
*
Do you wish to make your meal offering anonymously?
*
Yes
No
Do you wish to offer a special dedication to accompany your meal dana offering?
*
Yes
No
If you circle NO, please be aware our standard anonymous meal dedication reads:
"This meal is offered anonymously by someone present on this retreat" (or, as applicable "not present on this retreat").
If you would like to include a special dedication, please write out that dedication in the following box below exactly as you would like to have it read in its entirety. If you prefer not to include a special dedication, please be aware our standard non-anonymous meal dedication reads: "This meal is offered by Jane/John S. of YourTown, WA."
Special Dedication
*
What amount would you like to give to Cloud Mountain today?
$35
$50
$100
$250
$500
Other
Please tell us the amount you'd like to donate
$100 - Breakfast
$125 - Lunch/Brunch
$75 - Dinner
$300 - Full Day of Meals
Would you like to make this a recurring monthly donation?
*
Yes
No
For how many months?
*
Other Comments
General Information
First Name
*
Last Name
*
Street Address
*
Street Address Continued (Optional)
City
*
State / Province
*
Zip / Postal Code
*
Country
*
United States
Canada
Other
Please specify your country
Cell Phone
*
Alternate Phone
Email
*
Payment Summary
This retreat requires an initial $ deposit
*
Required Amount
Initial $ deposit.
Includes initial deposit plus any donations offered. Additionally, remaining balance will be charged on due date that is posted in retreat description and on your invoice.
Authorization (Initial Please)
*
By initialling, I authorize Cloud Mountain to process the payment of the amount above.
Payment Information
To donate by check or money order, please complete and print out this form and mail it along with your donation to the Cloud Mountain office at 373 Agren Rd. Castle Rock, WA 98611. Checks should be made payable to Friends of Cloud Mountain (or FOCM).
What kind of credit/debit card are you using?
*
-Please select a card type-
Visa
Mastercard
Credit Card Holder’s Name (as it appears on card)
*
Credit Card Number
*
Expiry Date (MMYY)
*
CVC/CCV Number
*
Billing Street Address
*
Billing Zip Code
*
Cloud Mountain 2019
Cloud Mountain 2019