Welcome Dharmavijaya Buddhist Vihara!

Membership

Dharma Vijaya Membership Application Form

Name: [Mr/Mrs/Ms/Miss/Dr/Rev]

Street Address:

City:

State:

Zip:

Home Telephone:

Office Telephone:

E-mail Address:

The sum of $ is being submitted for the following purpose:

Donation/Contribution of $ in remembrance of to invoke

blessings upon

Dana to the Maha Sangha of the Dharma Vijaya Buddhist
Vihara

$ Monthly Dana

$ Lump sum given in Lieu of Monthly Dana

Please reserve the following date and time for my/our
Dana:

Date: Time: AM/PM

Monthly Donation & Membership

$ for the maintenance of the Dharma Vijaya Buddhist

Vihara, Los Angeles, California; the upkeep of the Maha Sangha;
and membership in the Vihara.

Date: Signature: (type name)

(Please make check payable to: Dharma Vijaya Buddhist Vihara)