San Jose Buddhist Church Betsuin

640 North Fifth Street, San Jose, CA 95112

Phone (408) 293-9292

Fax (408)293-0433

Membership Form

I would like to become a member of the San Jose Buddhist Church Betsuin. I understand that the Betsuin is on a membership pledge system and that a packet of pledge cards will be forwarded to me.

Head of Household:

First Name Middle Last

Address

City State Zip

Phone Email

Which groups/organizations are you and your family involved in:

Adult Buddhist Association	Buddhist Women’s Association	Dharma School
Education	Finance	Historian
Japanese Language School	Membership	Ministerial
Morgan Hill	Property Management	Research and Planning
Sangha Support Committee	Senshi-kai	Betsuin or Jr. Choir
Young Buddhist Association	Youth Activities	Others:

Which of the above would you be interested in participating?

Other Interests? Extra-Curricular Activities?

Names of all family members included in this membership (include yourself):

Name (first middle)

Relationship

Birthdate

Occupation

Would you like to volunteer your talents or time at the Betsuin? Yes No

How?

Welcome to our Sangha.

In Gassho,

San Jose Buddhist Church Betsuin