Close and Return to Website 

A Gift of Prayer - Sponsorship Form

Your Personal Details

(R) = Required information
Name
(R) 		Address
(R)
City
(R) 		State
Postal/Zip Code
Country
(R)
Phone

Fax
E mail
(R) 		 
   

Beneficiary Information  (if sponsoring for a 3rd party)

Name
Address
City
State
Zip
Country
 

Puja Details

You may sponsor more than one Puja
King of Prayer
Medicine Buddha Puja
Cittamani Tara Puja
Green Tara Puja w/ praises to 21 Taras
Guru Puja and Tsog
White Tara Puja
Mahakala Puja

Length of Sponsorship

US $ 100 per puja per year (R)

Please inform the Beneficiary (R)

Dedication for prayers
 

Paying for Your Gift of Prayer - Please choose an option (R)
 
I will pay by Credit Card . I will send a Draft of Personal Check

After submitting this form you will be able to make a secure on-line payment through the FPMT credit card facility.

Please contact me about the best way for me to pay

Total Amount in US$ (R)

You will receive an e-mail confirmation outlining your payment details. Please print this e-mail and post it along with your draft or check to the below address. Please make payable to"FPMT inc" in US dollars. Personal checks can only be sent by US residents.

FPMT Inc
1632 SE 11th Avenue,
Portland OR 97214-4702
USA
Phone 1 + 503.808.1588
fax 1+ 503.808.1589
 

Comments

 



This will not submit your data.
You will be able to preview and confirm your entry before submitting