Please print out this form, complete the information below and mail it with your tax-deductible check or money order payable to Zangdokpalri Foundation to:

___$5,000

___$1,000

___$500

___$250

___$100

___$50

$______Other amount

___Please contact me regarding estate planning (gift in my will) or a living trust gift.

___Use Where Most Needed
___Temple Construction Project
___Construction of the new College building
___Construction of the nun's Retreat Center
___Monthly Support of Monks & Nuns

Name: ________________________________________________________________

Address: _______________________________________________________________

City/State/Zip: _______________________________________________________________

Country: _______________________________________________________________

email (optional): ________________________________________________________________