Mountain Source Sangha Membership Form
Name_____________________________________
Address___________________________________
__________________________________________
Phone____________________
E-Mail ____________________
Monthly Contributions (please circle)
Supporter $25 $50 $75 $108 Other _____
Benefactor $125 $150 $200 $300 Other _____
One-time Contributions of any amount are always welcome. ______
Print
out form and make checks payable to Mountain Source Sangha and mail to:
262
Alpine St, San Rafael, CA 94901
We are registered as a Non-Profit Religious Corporation. All donations are tax deductible. Tax receipts are available upon request.