The Guhyasamaja Center

www.guhyasamaja.org

~ P L E D G E F O R M ~

Date: _________________

Name: _____________________________________________________________

Address: ___________________________________________________________

___________________________________________________________________

Phone: _____________________________________________________________

Email: ______________________________________________________________

Donation Amount:

_____ dollars per month for __ months; anticipated start date: _______________

OR a

One time donation of: $____

Please put your completed form on the registration table at a Center event, or mail it to The Guhyasamaja Center, 4339 Alton Place, NW Washington, DC 20016.

Thank you for making Ven Khensur Rinpoche’s Dharma teachings possible in the D.C. area!

The Guhyasamaja Center was founded in 1994 by Lama Zopa Rinpoche. We are a member of the worldwide Foundation for the Preservation of the Mahayana Tradition, an international family of city and retreat centers, monasteries, publishing houses, hospices, and healing centers who share our purpose.