加拿大靈巖山寺傳授在家三皈五戒菩薩戒報名表/Lingyen Mountain Temple (Canada) Precepts Transmission Ceremony Registration Form 受戒類別/Category五戒/Five Precepts菩薩戒(戒會中會兼受五戒)/Bodhisattva Precepts (Five Prercepts will also take in the ceremony)只參加戒會課程/Take Precepts Class Only是否首次受戒/Not Taken Precepts首次/I have not taken precepts增益戒/I have taken precepts beforeSeparator1中文姓名/Chinese Name英文姓名/English Name皈依法名/Dharma Name性別/Gender男/Male女/Female出生日期/Date of BirthSeparator3出生地/Birth Place國家/Country省分/Province城市/CitySeparator4國籍/Citizenship年齡/Age語言/Language漢語/Mandarin Chinese廣東話/Cantonese英語/EnglishOther需要翻譯機/English Translation Needed需要/Yes不需要/NoSeparator5通訊地址/Mailing Address城市 /City省分 /Province郵遞區號/Postal CodeSeparator6住宅電話號碼/Home Phone Number手機電話號碼/Cell Phone NumberSeparator9電子信箱/Email AddressSeparator14學歷/Education博士/Ph.D碩士/M.學士/Ba.專科(學院)/College中學/Secondary小學/ElementarySeparator10皈依寺院或地點/Place of Taking Refuge皈依師長德號/Spiritual Teacher皈依寺院/Temple Name皈依日期/Date of Taking RefugeSeparator11身高/Height呎/ft吋/in公分/cmSeparator15體重/Weight磅/lb公斤/kgSeparator12身體特殊狀況/Physical Condition跪拜/Able to prostrate . kneel能/Yes否/NoSeparator13日常所修法門及研讀經論/Your usual form of cultivation and the name of Buddhist scriptures you most often study經常參拜之寺院/Temple regularly visitedSeparator2緊急聯絡人/Emergency Contact姓名/Name關係/Relationship聯絡人住宅電話/Contact Home Phone Number聯絡人手提電話/Contact Cell Phone Number送出/Send Error occured. Please confirm your data and submit again:
