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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)
August 09, 2019-Resting Into Naturalness
August 30, 2019-Awakening
September 20, 2019-When Awareness Becomes Natural
October 04, 2019-Mindfulness of Mind
November 08, 2019-Quieting the Mind, Awakening the Heart: An Insight Meditation Retreat
November 22, 2019-Vipassana Meditation: Seeing Clearly What's True -- A Retreat for New Students
December 06, 2019-Volunteer Work Weekend
December 29, 2019-Releasing and Greeting the New Year with Dhamma
July 26, 2019-‘Drop by drop the water jar fills’: Spiritual faculties overflow in the heart’s release
August 16, 2019-Anapanasati: Mindfulness with Breathing
September 27, 2019-Mindfulness, Insight & Liberation - for experienced students
October 11, 2019-Deepening into Awareness & Wisdom: For Intermediate & Advanced Students
November 01, 2019-Guardians of the Heart: Vipassana and the Four Brahma Viharas
October 18, 2019-Practicing with Depression and Anxiety: Waking up through Difficult Emotions
For which retreat are you offering your meal dana?
Any (No preference)
August 09, 2019-Resting Into Naturalness
August 30, 2019-Awakening
September 20, 2019-When Awareness Becomes Natural
October 04, 2019-Mindfulness of Mind
November 08, 2019-Quieting the Mind, Awakening the Heart: An Insight Meditation Retreat
November 22, 2019-Vipassana Meditation: Seeing Clearly What's True -- A Retreat for New Students
December 06, 2019-Volunteer Work Weekend
December 29, 2019-Releasing and Greeting the New Year with Dhamma
July 26, 2019-‘Drop by drop the water jar fills’: Spiritual faculties overflow in the heart’s release
August 16, 2019-Anapanasati: Mindfulness with Breathing
September 27, 2019-Mindfulness, Insight & Liberation - for experienced students
October 11, 2019-Deepening into Awareness & Wisdom: For Intermediate & Advanced Students
November 01, 2019-Guardians of the Heart: Vipassana and the Four Brahma Viharas
October 18, 2019-Practicing with Depression and Anxiety: Waking up through Difficult Emotions
Are you flexible as to the date on which your meal dana is offered?
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Yes
No
What specific date are you requesting?
*
Do you wish to make your meal offering anonymously?
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Yes
No
Do you wish to offer a special dedication to accompany your meal dana offering?
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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)
*
Please initial to confirm that you have read and understand Cloud Mountain's retreat attendance and cancellation policy.
By initialling, I authorize Cloud Mountain to process the payment of the amount above.
Payment Information
Online registration is through credit or debit card. The following forms of payments are accepted:
Visa • MasterCard • Discover • American Express • JCB • PayPal • Visa Checkout • Apple Pay • Chase Pay
To register by check or money order, please return to the registration section of our website, print out a paper form, and mail it in along with payment to the Cloud Mountain office.
Credit Card Holder Full Name
*
Credit Card Number
*
Expiry Date (MMYY)
*
CVC/CCV Number
*
Billing Street Address
*
Billing Zip Code
*
Cloud Mountain 2019
Cloud Mountain 2019