Membership application form

If you would like to become a member of Sakyadhita UK, complete, print and mail the following form to the stated address. Please send it also as an e-mail message to gassner@sakyadhita-europe.org. For donations please use this form

I would like to contribute to the valuable work of Sakyadhita UK by becoming a member.

Name:         ____________________________________________________________

Full address: ____________________________________________________________

Postcode:     ____________________________________________________________


Telephone: _______________    ___________________

E-mail:    ________________@_____________________



[ ] GBP  15.00 membership for one year
[ ] GBP   8.00 concessionary membership for one year (eg nuns, low waged)           
[ ] GBP 150.00 lifetime membership

Please make cheques payable to Sakyadhita UK

and send to the Membership Secretary:

Beatrice Jutta Gassner, 77 Earlham House, Earlham Road, Norwich NR2 3PF

Or if you wish to pay by BACS direct to our bank account:

Co-operative Bank 	Sort Code 	08-92-99 
			Account number	65279850
			Account name	Sakyadhita UK

and please use your name as the reference
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UK Income Tax payer  [Yes] [No]		
USA Income Tax payer [Yes] [No]



Signature_____________________________Date _____________________________


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