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Zen Peacemakers Sangha
Membership Application Forms

  • Membership Form
  • Senior's Data

Please fill out the form below and push the submit button (at the bottom of the form), the return key,
or the enter key to send it to us. The tab key will take you from field to field.

I request that our group/circle/zendo/community:
Group Name:
be granted membership in the Zen Peacemaker Sangha, a free offering of the Zen Peacemakers.

Our Group's Website URL is:

Requestor's First Name Requestor's Last Name

Requestor's Dharma Name

Requestor's Title

Group's Address

Group's_Address2

City State or Province

Country Zip Code


Requestor's Home Telephone               Group's Office Telephone                                     Requestor's Cellular Telephone
                                         

Requestor's E-Mail Address



As a member, we will display our membership in the Zen Peacemaker Sangha on appropriate documents, including our website, letterhead stationary, advertisements and in public announcements.

We will also provide to Zen Peacemaker Sangha, and keep current, a list of members who have been empowered as seniors. Please link on the Seniors tab at the top of this page for the definition of ZPS Seniors.

Comments:

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If you have questions please contact:

Laurie Smith
Zen Peacemakers Sangha
177 Ripley Road
Montague MA, 01351
413-367-5268

program_info@zenpeacemakers.com

Please fill out the form below for each Senior of your Group and push the submit button (at the bottom
of the form), the return key, or the enter key to send it to us. The tab key will take you from field to field.


Group Name:

Senior's First Name Last Name

Dharma Name

Senior's Title

Empowered by:

on date:

Senior's Address

Address2

City State or Province

Country Zip Code


Senior's Home Telephone               Senior's Office Telephone                                     Senior's Cellular Telephone
                                         

Senior's E-Mail Address



After submitting the information for this Senior, please repeat the process for all of the Seniors in your Group.

sr's_Comments:

Image Verification
Please enter the text from the image
( Refresh Image ) ( What's This? )


If you have questions please contact:

Laurie Smith
Zen Peacemakers Sangha
177 Ripley Road
Montague MA, 01351
413-367-5268

program_info@zenpeacemakers.com