MVBT 2023 Membership Form

MVBT 2023 Membership Form
Thank you for supporting the Mountain View Buddhist Temple through membership! We welcome people of all ages, ethnicities, genders, sexual orientations, and races to join the Sangha (community).

As a member, you are part of a supportive family, a connected group of friends, a vibrant Buddhist community, and a place that feels like a home. The members (Sangha) of the Mountain View Buddhist Temple are its life blood – your membership supports the day-to-day operations and expenses for maintaining the Temple, our programs, and services.
Are you a New Member, or Renewing your membership?*

MVBT 2023 Membership Form
MVBT Membership Categories
Below are descriptions of membership categories. Each member can choose their level of support based on their interest and availability. Please select one to join.

Note: a portion of your dues is allocated to the Buddhist Churches of America (BCA).
Family Memberships

Sustaining Family

2 adults in a household; may include children under the age of 26
Full Temple Benefits

Additional funds help to strengthen the foundation of the Mountain View Buddhist Temple today and into the future.

$1,000.00

Family

2 adults in a household; may include children under the age of 26
Full Temple Benefits

$600.00

Individual Memberships

Sustaining Individual

1 adult in a household; may include children under the age of 26
Full Temple Benefits

Additional funds help to strengthen the foundation of the Mountain View Buddhist Temple today and into the future.

$500.00

Individual

1 adult in a household; may include children under the age of 26
Full Temple Benefits

$300.00

Associate Individual

1 Adult between the ages of 26-35
Full Temple Benefits

$150.00

Young Adult Individual

1 Adult between the ages of 18-25, or a full-time student

Limited Temple Benefits

Access to MVBT affiliate organization. No facility rental privileges.

$25.00

Community Individual

1 Adult

Limited Temple Benefits

May participate in affiliated organizations and all Temple events. Will not have any zone representation nor voting rights. Will not have access to the MVBT Nokotsudo or funeral services. Will not receive any facility rental discounts.

$120.00

Select Your Membership Level*
Membership Level
Membership Amount
Additional Donation
Members are encouraged to support the Temple through periodic financial donations and assistance with various activities, including annual fundraising events. If you would like to include an additional donation today, you can do so here.
Additional Donation (Optional)
Additional Donation
Used for the $0 placeholder in the Summary.
If the cost of membership is difficult for you or your family, we can help you with the cost of your membership. Please contact Reverend Mukojima at reverend@mvbuddhisttemple.org.
Total Due

Household Information
Has any of your Household information changed since your last membership? Please check all that apply.

Home Phone NumberHome Address
Primary Contact*

First NameLast Name
Home Phone
This should not be a mobile phone number.
*If your household does not have a Home Phone number, you may leave this field blank.
Home Address*

Street Address

Street Address – Line 2

CityState / Province

Postal / Zip Code
Toban Zones are assigned based on geographic location or personal preference. If you have a personal preference, please indicate so below.
Toban Zone Preference (Optional)
How many adults will be included in this membership?*
How many children (under age 26) will be included in this membership?*
Communications
Mountain View Buddhist Temple produces a monthly newsletter called The Echo. Would you like a paper edition of this newsletter sent to your home each month?
Receive a paper copy of The Echo?*
Paper Echo Opt-In

TRUE

Member Information
Adult #1
Full Name*

First NameMiddle Name (Optional)Last Name
Nickname (Optional)
Email*
example@example.com
Does this Email belong to a Proxy?*
Note: Each adult in the houshold will automatically be signed up for electronic versions of The Echo (the monthly temple newsletter) and Putra's Post (email of upcoming events). You can unsubscribe from these newsletters at any time through the "unsubscribe" link in the email you receive.
Mobile Phone
If different from Household Phone.
Preferred Phone*
Birthdate

MonthDayYear
Demographic Information
Gender – How do you identify?
Self-Describe
Employer
Occupation
University/College
Major/Focus
Proxy Information
Adult #1 Email is Proxy

TRUE
Proxy Name*

First NameLast Name
Proxy Relationship to Household*

Member Information
Adult #2
Full Name*

First NameMiddle Name (Optional)Last Name
Nickname (Optional)
Email*
example@example.com
Does this Email belong to a Proxy?*
Adult #2 Email is Proxy

TRUE
Mobile Phone
If different from Household Phone.
Preferred Phone*
Birthdate

MonthDayYear
Optional Information
Gender – How do you identify?
Self-Describe
Employer
Occupation
University/College
Major/Focus
Proxy Information
Adult #2 Email is Proxy

TRUE
Proxy Name*

First NameLast Name
Proxy Relationship to Household*

Member Information
Child #1
Full Name*

First NameMiddle Name (Optional)Last Name
Nickname (Optional)
Email (Optional)
example@example.com
Birthdate*

MonthDayYear
Note: Children's information will never be distributed nor published. If you would like your child to receive a copy of Putra's Post – our digital newsletter with upcoming events – please include their email.

Member Information
Child #2
Full Name*

First NameMiddle Name (Optional)Last Name
Nickname (Optional)
Email (Optional)
example@example.com
Birthdate*

MonthDayYear

Member Information
Child #3
Full Name*

First NameMiddle Name (Optional)Last Name
Nickname (Optional)
Email (Optional)
example@example.com
Birthdate*

MonthDayYear

Member Information
Child #4
Full Name*

First NameMiddle Name (Optional)Last Name
Nickname (Optional)
Email (Optional)
example@example.com
Birthdate*

MonthDayYear

Emergency Contact(s)
In the event of an emergency, the adult members of this household will be the first contacted. Please provide the contact information for at least one additional adult outside of your household who can serve as an emergency contact.
Emergency Contact #1
Name*

First NameLast Name
Relationship*
Primary Phone*
Please enter a valid phone number.
Add another Emergency Contact?*
Emergency Contact #2
Name*

First NameLast Name
Relationship*
Primary Phone*
Please enter a valid phone number.

Membership Dues – {membershipLevel}	${membershipAmount}
Additional Donation (Optional)	${additionalDonation}
Total Due	${totalDue}

MVBT 2023 Membership Form

MVBT 2023 Membership Form

MVBT Membership Categories

Family Memberships

Individual Memberships

Additional Donation

Household Information

Communications

Member Information

Adult #1

Demographic Information

Proxy Information

Member Information

Adult #2

Optional Information

Proxy Information

Member Information

Child #1

Member Information

Child #2

Member Information

Child #3

Member Information

Child #4

Emergency Contact(s)

Emergency Contact #1

Emergency Contact #2

Summary and Payment Information

Temple Directory

Contribution Summary

Payment Options

Credit Card