Santavana Forest Hermitage 參訪:六、日9AM-6PM;其他時間:預約接待
Phone:+6016 5568715(8AM-11AM)
800-123-456
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方丈開仁長老 Abbot Thera Kairen
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住宿表格 Accommodation Form
網上報名Online Application
諸位法友們,大家好!
請仔細閱讀及根據您個人的實際狀况,正確地填寫表格。
如果您的
填寫有錯誤
,系統將出現
紅色標示提醒
,請修正以便成功提交。如果提交報名表格成功,您將會收到一份電子郵件,以便確認網上報名登記已成功。
謝謝!
Greetings, all dhamma friends!
Please read the regulations carefully and complete the application form with accurate information.
All invalid entries will be highlighted in red
. Please correct them before submission.You will receive a reply email when the submission is successful.
Thank You!
身份 Identity:
*
在家
Lay
僧伽
Sangha
出家法號 Ordination name:
*
英文姓名 Name:
*
中文姓名 Chinese Name:
皈依法名Dharma Name:
出生日期 Birth Date:
*
Year
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
年齡 Age:
*
性別 Gender:
*
男
Male
女
Female
身份 Identity:
*
比丘
Bhikkhu
比丘尼
Bhikkhuni
式叉摩那
Sikkhamānā
沙彌
Samanera
沙彌尼
Samaneri
國籍:
*
Malaysia
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Greenland
Grenada
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Northern Mariana Islands
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Sudan, South
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Yemen
Zambia
Zimbabwe
身份證號碼 NRIC No.:
*
外國籍請填護照號碼
(Passport no. for foreigner):
宗教信仰 Religion:
*
職業 Occupation:
*
出家道場 Place of first ordination:
*
出家依止師 Acariya:
*
出家日期 Date of taking ordination:
*
受具足戒道場 Place of higher ordination:
*
受具戒師 Preceptor at higher ordination:
*
受具足戒日期 Date of taking higher ordination:
*
健康狀況 Health conditions:
*
良好
Healthy
欠佳
Unhealthy
欠佳狀況 Unhealthy conditions:
*
高血壓
Hypertension
心臟病
Heart disease
糖尿病
Diabetes
肝炎
Hepatitis
胃病
Gastric
哮喘
Asthma
打鼾
Snoring
情緒困擾或心理疾病
Emotional disorder or mental illness
其他
Others
請註明其他病況 Please specify:
*
血型 Blood Type:
*
A
B
AB
O
不知
Unknown
學歷 Education Level:
小學
Primary
中學
Secondary
大學、大專
University or College
碩士
Master
博士
Doctorate
聯繫電話 Telephone:
*
電子信箱 Email:
*
通訊地址 Address:
*
推薦人Referred by:
*
推薦人單位 Referrer's Monastery:
*
推薦人電話 Referrer's Contact Number:
*
緊急聯絡人 Emergency Contact Person:
*
關係 Relationship :
*
緊急聯絡人電話 Emergency Contact Number:
*
住宿目的 Purpose of staying:
*
義工
Volunteers
禪修
Meditation
上課
Attending class
其他
Others
請註明其他住宿目的 Please specify:
*
住宿日期 Accomodation Date:
*
Date Format: DD slash MM slash YYYY
從
From
*
Date Format: DD slash MM slash YYYY
至
To
備註 Remarks:
聲明 DISCLAIMER
本人願意於寂靜禪林住宿期間遵守一切規約,並聲明以上所填寫之資料正確無誤。
I shall obey the rules and regulations of the monastery during my stay. All the information I have provided above is true.
簽名 Signature :
*
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