Work retreatant short term volunteer application form

Name Name First Last
Email
What dates are you applying for? Please check the website for availability.
Date of birth
Gender
Nationality
Your mobile phone number with country code
Your home address
Understanding of English
Compréhension du français
Emergency contact details, name, phone number and relationship, i.e friend, parent etc.
How did you hear about le Moulin
Have you been to the Moulin before?

Have you been to the Moulin before? yes no
If you have been before then please give the details of your visit or visits.
Mention your previous meditation experience, dates, teachers, etc.
Have you ever served or managed at a meditation/ Dharma centre or personal development centre before? Please give details.
Please give details of your work skills that may be useful during your time here.
Why are you applying to volunteer here?
Do you have any physical limitations that might impact your ability to participate in the work?
Do you have any special dietary requirements?
Do you drive and do can you bring a licence with you?
The following information will be kept strictly confidential. Please feel free to add further details if necessary.
Psychological history -
Are you currently using any prescribed medications for a mental health condition?
If so please give the name of the medication and confirm that any treatment you are taking at the time of your retreat, you will continue to take throughout the duration of your retreat:
Do you have a criminal record? If so please give dates and details.
Are there any additional factors concerning your current life circumstances of which you would like to inform the teacher(s), or feel it would be help for them to know?
I agree to follow the rules of the Moulin de Chaves, and take complete responsibility for myself and my actions during my participation in the activities of the association. I understand especially, that the river is unsupervised and any swimming undertaken for either myself or any children in my care is entirely at my own risk.

I agree to follow the rules of the Moulin de Chaves, and take complete responsibility for myself and my actions during my participation in the activities of the association. I understand especially, that the river is unsupervised and any swimming undertaken for either myself or any children in my care is entirely at my own risk. Yes

Work retreatant short term volunteer application form

Work retreatant short term volunteer application form

The following information will be kept strictly confidential. Please feel free to add further details if necessary.