Buddha's Light International Association, Boston Chapter Application Form for Membership

國際佛光會波士頓協會會員入會申請表

Annual Membership Fee – $40

BLIA Boston Membership Application Form

Name (英文) *

姓名(中文)

Date of Birth / 出生日期 *

Gender / 性別 * MF

Phone / 電話 *

Email / 電郵 *

Address / 地址 *

Address / 地址

Address / 地址

Address / 地址

City

City

State/Province

State/Province

Zip/Postal

Zip/Postal

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Country

Education / 學歷

Occupation / 職業

Experience / 經驗

Special Skill - Hobby / 專長 - 嗜好

Dharma Name / 皈依法名

Master's Name / 皈依法師德號

Five Precepts / 五戒

Bodhisattva Precepts / 菩薩戒

Reference's Name / 介紹人姓名

Reference's Phone / 介紹人電話

Branch / 所屬分會 *

Cambridge Sub-Chapter / 劍橋分會

Springfield Sub-Chapter / 春田分會

2"x2" color photos / 二寸彩色照片 *

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