佛光山西來寺光明燈功德登記表

佛光山西來寺光明燈功德登記表

Registration form for Light Offering
捐款人姓名*
Name of Benefactor
性別 (Gender)

男 (Male)女 (Female)
電話*
Contact Number: ex. 1112221212
生日

MonthDayYear
Birthday
電子郵箱*
E-mail
佛光卡號碼
Fo Guang Card No. ex. M1234567
地址 (Address)*
全年光明燈 (Name of Yearly Light Offering)
供齋(Food Offering）
供花果（Flower &Fruit Offering）
付款方式 (Payment Method)*

Paypal/Credit CardCheck (支票抬頭請寫Please make check payable to I.B.P.S.)
支付人(支票或 PayPal )姓名*
Payment made by
收據抬頭為PayPal／check支付人姓名)

Name on the receipt must be the name on the check, the name of PayPal account or the name of credit cardholder.
需要收據? (Need a Receipt?)*

YesNo
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Leave us a message
如果您是付支票，請勿填寫總金額，直接按 Submit.
If you are paying by check, please skip the total amount and hit “Submit.”
功德款 Total Amount

prevnext( X )
USD總計

Payment Methods

Debit or Credit Card

First Name

Last Name

Credit Card Number

Card Expiration

Security Code

Please click one of the PayPal options to complete payment and submit the form.

佛光山西來寺 光明燈功德 登記表