Deer Park Summer Course 2004
July 5th - August 8th

Registration Form

*Please submit one form per person

Name: ___________________________________ Ordained Nun: __ Ordained
Monk: __

Mailing Address: ______________________________________

______________________________________

______________________________________

Email Address: ______________________________________

Phone: _________________

If arriving late, please enter an estimated date of arrival: ______________

If lunch is provided, I would like to participate: Non-vegetarian __
Vegetarian __

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Sangha Only: I will need financial assistance for rent at Deer Park:
Full __ Partial __
I will need financial assistance for lunch, if provided:
Full __ Partial __
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Amount Enclosed:

Course Deposit ________ (minimum $150)

Full Payment ________ ($375)

Donation for Sangha ________ (to help Sangha pay for housing at Deer
Park and lunch)

Other ________ Purpose: ______________________________

TOTAL ________

THANK YOU

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