贊助人表格 Sponsorship’s form

• 網上報名

  敬愛的贊助人：請詳細閱讀及正確填寫表格資料。如果成功提交報名表格之後，您將會收到一份電子郵件確認信，表示您已登記成功。感謝您的護持！

  Dear friends, please read carefully and fill in the accurate information. A reply mail will be sent to you if succeed in submission, Thank you.

• 皈依法名Dharma Name:
• 英文姓名 Name：*
• 中文姓名 Chinese Name:
• 性別 Gender:*
  • 男 Male
  • 女 Female
• 國籍：*
  AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayNorthern Mariana IslandsOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe
• 身份證號碼 NRIC No.:*
  外國籍請填護照號碼(Passport no. for foreigner)
• 聯繫電話 Contact No.：*
• 電子信箱 Email:*
• 通訊地址 Address:*

• 聲明 DISCLAIMER

  本人願意成為寂靜禪林之贊助人，并於每月定時或不定時贊助禪林一切活動與建設開銷。若欲停止捐款，亦將會以書面正式通知寂靜禪林。

  I am willing to donate to Santavana Forest Hermitage monthly or as when needed, in contribution to expenditure incurred in all activities and construction works. I will write in formally if I wish to withdraw my sponsorship.

• *
  • 現款 Cash
  • 支票 Cheques
  • 匯款 Bank in
• 贊助數額 Amount Donate:*
  • RM20
  • RM50
  • RM100
  • 其他 other RM
• 其他 other RM*
• 備註 Remarks:
• 簽名 Signature ：*