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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
*
M
F
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
Country
Afghanistan
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China
Christmas Island
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Colombia
Comoros
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Cook Islands
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Croatia
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Curacao
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Dominican Republic
East Timor
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El Salvador
Equatorial Guinea
Eritrea
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Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
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Guinea
Guinea-Bissau
Guyana
Haiti
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Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
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Italy
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Japan
Jersey
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Kiribati
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Kuwait
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Latvia
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Lesotho
Liberia
Libya
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Lithuania
Luxembourg
Macao
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
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Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
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Samoa
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Senegal
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Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
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Sweden
Switzerland
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Tonga
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Tuvalu
Uganda
Ukraine
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United States
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Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
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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