佛光山西來寺供齋花果贊普登記表

佛光山西來寺供齋花果登記表

Blessing Donation Form
捐款人姓名*
Name of Benefactor
性別 Gender*

男 (Male)女 (Female)
電話 Phone*
Contact Number
電子郵箱*
E-mail
地址*
Address
出生日期

MonthDayYear
Birthday
佛光卡號碼
Fo Guang Card No.
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
需要收據? (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?)

NoYes
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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.

佛光山西來寺供齋花果登記表