Buddhasavika Foundation

                
Membership No.............

MEMBERSHIP APPLICATION FORM

Name of Applicant : ..............................................                  
Name of Spouse (if applicable) :...................................

Date of Birth :.................................       Status:...................................

Mailing Address:.................................................................................................................

Tel :..............................................   Fax. Email :...............................................................

Occupation : .....................................................................
Qualification :....................................................................

Name & Address of Employer :.....................................................................................

Tel. :.............................................   Fax :........................................................

Present/Previous involvement in Buddhist Activities:.............................................
........................................................................................................................................

Signature :...................................   Date :.....................................................

Proposer :....................................................................

For Official Use Only

Date Receive :....................................... Status : Accepted/Rejected

       The completed form should be returened together with US $12 (Entrance Fee and Annual Subscription)
            Send this application form to
Buddhasavika Foundation P.O. Box 108, Nakhonpathom, Thailand 73000
            Payment by cheque/money order should be made to Ven. Dr. Chatsumarn Kabilsingh <
chatsumarn@hotmail.com>
         You will receive Yasodhara English Newsletter four issues annually by air-mail.


Wish Fulfilled Garden A Dharma Garden 

Back      Buddhasavika Foundation


 Songdhammakalyani  Temple  195 Petkasem Highway Muang District, Nakhonpathom Thailand 73000
Tel.& Fax.  660 3428 4315   E- mail :
dhammananda99@hotmail.com
Copyright (c) 2002-2003 Thaibhikkhunis.org  All rights reserved.