Fo Guang Shan Hsi Lai Temple Five Precepts and Bodhisattva Precepts - Registration

    English Name:      Chinese Name:  

    Gender: Male    Female                         Date of Birth:

    Dharma Name:          Nationality:

    Spiritual Teacher:        Refuge Date:       

    Place of Refuge:

    Marital Status:  Single   Married   Divorced   Other

    Address:

    Telephone:  Home        Office       Fax

               Cell Phone        E-Mail

    Education:           I.D. No:

    Experience:

    Occupation:    

    Language Used:   Chinese    English    Cantonese     Other

    Heights:  ft. in.      Weight:  lb       Chest Measurement: in.

    Request Which:   Five Precepts (New)    Five Precepts (Renew)    

                               Bodhisattva Precepts (New)     Bodhisattva Precepts (Renew)

    Health condition:  

    Reference: