Membership Form

Please Fill out and Print

DATE

Get your KSDL Email address

KSDL email address (if desired): @KSDL.ORG
Examples: "Ben" or "Val"

Password:
Must be six characters or more

Your Password and Username will be used to access your Email and Productivity tools

Member Information

First Name: Last Name:

Current Email: Phone #:

Address: City:

Province/State: Country:

ZIP/Postal Code:

 

Please choose one of the following:

Basic Membership:

$30 per month

$50 per month

$70 per month

$100 per month

Other amount (please specify)

Please pay by post-dated cheque or cash, monthly or by lump sum. Make cheques payable to Karma Sönam Dargye Ling. If you cannot pay by these methods please speak with Tenzin at 416 653-5371.

A tax receipt will be issued for all annual contributions of $100 or more. Thank you for your generous support!

KARMA SÖNAM DARGYE LING • 86 Vaughan Road, Toronto, Ontario M6C 2M1 PHONE: 416 653-5371 • WEB SITE: www.ksdl.org • E-MAIL: info@ksdl.org