Name: Relationship: Contact Number: Email Address: 3. Educational Information Highest educational level completed: Major: Name of Institute: Place: Year: Your Activity during study (Year/Activity/in What level): 1. 2. 3. 4. 5. How about your English Skills? 1. Listening………………………2. Speaking…………….……3. Writing……………….…4. Reading…………..…… How about your Computer Skills? 4. Professional Information Name of Company: Department: Type of business industry/line: Your Position and Job responsibility: 6.Thailand Entry information Passport Number: Expiration Date of Passport: Country of Issued: Thai Visa Number: Type of Visa: Expiration Date of Visa: 7. Meditation Experience 7.1 Have you ever meditated before? (Yes/No): If yes, since ……………………………. What is the technique of meditation you use regularly?: How often? …………………………….. 7.2 What is your best experience? 7.3 Are you interested in The Middle Way Meditation? (Yes/No): If yes, why…………………………….. 8. Additional Information Do you smoke? If so, how often and how many cigarettes per day? Do you drink alcohol? If so, how often? Do you suffer from any emotional or mental problems, e.g., depression, traumatic stress disorder, etc.? (If yes, please specify) Do you take regularly prescribed medication? (If yes, please specify) Do you take alternative health remedies? (If yes, please specify)
Name: Relationship: Contact Number: Email Address: 3. Educational Information Highest educational level completed: Major: Name of Institute: Place: Year: Your Activity during study (Year/Activity/in What level): 1. 2. 3. 4. 5. How about your English Skills? 1. Listening………………………2. Speaking…………….……3. Writing……………….…4. Reading…………..…… How about your Computer Skills? 4. Professional Information Name of Company: Department: Type of business industry/line: Your Position and Job responsibility: 6.Thailand Entry information Passport Number: Expiration Date of Passport: Country of Issued: Thai Visa Number: Type of Visa: Expiration Date of Visa: 7. Meditation Experience 7.1 Have you ever meditated before? (Yes/No): If yes, since ……………………………. What is the technique of meditation you use regularly?: How often? …………………………….. 7.2 What is your best experience? 7.3 Are you interested in The Middle Way Meditation? (Yes/No): If yes, why…………………………….. 8. Additional Information Do you smoke? If so, how often and how many cigarettes per day? Do you drink alcohol? If so, how often? Do you suffer from any emotional or mental problems, e.g., depression, traumatic stress disorder, etc.? (If yes, please specify) Do you take regularly prescribed medication? (If yes, please specify) Do you take alternative health remedies? (If yes, please specify)
MMI-Peacemaker-Application-Form.docx