Distance Teaching Inquiry

Please fill out the following form and an auto reply will be e-mailed to you. The form results will go to Richard Johnson. At present this form is a demo for how FoH can set up questionnaires and email replies to hopefully avoid spammers.

Name: (NOTE: This field is REQUIRED)

E-Mail Address: (NOTE: This field is REQUIRED)

What kind of meditation practice is your primary one now?

What are you aspirations or goals in meditation practice? (Select all that Apply):
Calm, peace and less anxiety
Better work and family life
Awakening
More love and sensitivity for others
Be more effective in bringing love and peace into this troubled world

Q1: How long have you practiced?
None Less than 1 year 1 to 3 years 3 to 10 years More than 10 years

Q2: How often do you practice meditation?
Never Practiced
Occasionally--no regular schedule
1-4 times per week
Daily = 5 to 7 times per week
Twice daily = 5 to 7 times per week

Q3: Have you studied directly with a teacher before?
Never
Only in retreat
Yes, but no longer with this teacher
I am currently working with a teacher

Detailed Questions (NOTE: This field is REQUIRED):