佛光山西來寺彌陀聖誕功德登記表 Amitabha Buddha's Birthday Celebration Registration Form

佛光山西來寺彌陀聖誕功德登記表

Amitabha Buddha's Birthday Celebration Registration Form
捐款人姓名*
Name of Benefactor
性別 Gender*

男 (Male)女 (Female)
電話 Phone*
Contact Number
出生日期*

MonthDayYear
Birthday
電子郵箱*
E-mail
佛光卡號碼
Fo Guang Card No. ex. M1234567
地址*
Address
供齋 (Food Offering)
供花果(Flower & Fruit Offering)
供壽桃(Longevity Peach Offering)
留言
Leave us a message
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.
付款方式 (Payment Method)*

Paypal/Credit CardCheck
支付人(支票或 PayPal)姓名*
Payment made by
需要收據? (Need a receipt?)*

NoYes
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

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