Retreat Registration

Three-day Labor Day Retreat, Sanger – September 4-7, 2015





Language 語言 (required)

Gender 性別 (required)

First and Last Name 名字和姓氏 (required)

Chinese Name 中文名, 請以中文填寫

Year of Birth 出生年份 (required)

Country Calling Code (required)

Telephone No. 電話 (required)

E-mail 電郵 (required)

Address 地址 (required)

Photo 相片

Please submit a file not larger than 500 kBytes. Acceptable file types are: jpg, jpeg, png, tiff, bmp.
請上載個人照片一張,檔案不能大於 500 kBytes。

 

Religious Affiliation or Group (if any); Optional for non-Buddhists

Have you taken refuge in the Buddha? (required)

          If yes, please give the year you took refuge
          

          If yes, are you a Master of Dharma Listening Session or a Rinpoche? 你是否聞法上師或仁波且?
          

          If yes, please give the name of your refuge master 皈依師
          

          If yes, please provide your dharma name, if you have one 法名
          

          If yes, do you have a refuge certificate/booklet that contains your daily practice? 你是否有皈依證用作每天修持?
          

          Refuge Location (City, Province, Country) 皈依地點 (城市,省份,國家)
          

          If no, do you wish to take refuge with Venerable Zhaxi Zhuoma? 你是否希望皈依扎西卓瑪尊者?
          

Do you wish to receive dharma from Venerable Zhaxi Zhuoma? 你是否希望向扎西卓瑪尊者求法?

          If yes, which dharmas have you received? 求法者需填寫,你至目前為止已經接了什麼法?
          

          If yes, which dharmas do you wish to receive? 你希望求什麼法?
          

Do you wish to request an interview with Venerable Zhaxi Zhuoma for any other reason? 你是否有其他事希望求見扎西卓瑪尊者?

          If yes, what is the reason for the interview? 請略為說明求見尊者的緣起?
          

Experience in meditation 禪修經驗

Do you have any food allergies? If you have, which ones? 有沒有食物過敏?若有,請說明。

Emergency Contact 緊急聯絡人

Name 姓名 (required)

Country Calling Code (required)

Telephone No. 電話 (required)

Total fees 費用: $120

The fees are the minimum recommended donation to cover cost of food, utilities, etc. while staying at the temple. If you plan on attending, but will be staying elsewhere overnight, you do not need to register, but can contribute to the cost of food as appropriate. Do let Zhaxi Zhuoma know of any meals you plan on taking at the temple.

Limited to 13 people. Registration accepted on a first come basis. Payment for registration is non-refundable.  
名額只限13人,報名先到先得。核實尚有名額後,本會將發電郵通知。

Fee Policy 收費政策:
Registration fee is non-refundable and participation is non-replaceable.
若不能參加,費用不作退款。亦不可更換參加者取代。

You will be automatically redirected to Paypal after registration. To complete your registration you will need to pay the retreat fee using Paypal.
填妥以上表格後,按 "寄出"後,將會到達貝寶網頁,請以貝寶繳交費用,完成報名手續。