义工报名 Volunteer Application – Info @ Dhamma Earth 法域

注意：建议使用电脑的浏览器填写。使用手机填写也许会因为浏览器问题无法上载照片。

Note: You are advised to use browser on computer to fill in instead of mobile phone to ensure smooth application filling process.

*如果在网上报名有问题，请发电邮到 retreat.dekl@dhammaearthint.org，注明“禅修报名表格”，我们将回复Ms Word报名表格给您。

If you have problem applying online, please send an email with “Retreat Application Form” in subject field to tusitasupport@gmail.com . We will send you the form.

由于技术问题，请使用 Google 或 QQ 邮箱申请。 Due to technical issues, please kindly use Google or QQ email to apply.

法域弟子要学会的美德 The virtues that students of Dhamma Earth should learn:
易受法 Easy to be admonished
易受教 Easy to receive Dhamma teachings
易护持 Easy to be supported

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服务道场 Volunteer Location*

服务开始日期 Volunteer Start Date*

请在您想要来服务的日期至少一个星期前提交申请。 Please submit your application at least one week before the date you would like to come to volunteering.

请勿在被批准前擅自购买机票。Please DO NOT buy flight tickets prior our approval of your application.

服务结束日期 Volunteer End Date*

姓名 Name*

依护照/IC as per Passport/IC

法名 Dhamma Name

出生日期 Date of Birth*

国籍 Nationality

马来西亚人 Malaysian

非马来西亚人 Non-Malaysian

国籍 Nationality *

护照号码 Passport No*

护照截止日期 Passport Expiry Date*

签证截止日期 Visa Expiry Date

性别 Gender*

宗教 Religion*

身份证号码 NRIC No *

电话 Contact Number*

Eg: +6010-1234567

电邮地址 Email address*

专业领域 Area of Profession

职业 Occupation*

通讯地址 Correspondence Address*

州/省/区域 State/Province/Region*

市 City*

州 State*

邮政编码 Postcode*

国家 Country*

个人照片上载 Photo Upload*

正面照 Front Portrait Photo

Untitled

紧急联络人姓名 1 Emergency Contact Name 1*

关系 1 Relationship 1*

联络电话 1 Contact Number 1*

紧急联络人姓名 2 Emergency Contact Name 2*

关系 2 Relationship 2*

联络电话 2 Contact Number 2*

禅修方法 Type of Meditation Practice

禅修老师 Meditation Teacher

你是否曾经在任何法域道场（或兜率天修行林）修行或服务过？Have you practiced or served at any Dhamma Earth monastery or Tusita Hermitage in the past? *

是 Yes

否 No

如果有，请简述何时，多久与向哪一位禅师学习（禅修）或服务内容。 If so, please give a brief description of when, the duration, and under which Teacher(s) guidance (for retreat) or your service content.

你是否有较严重的疾病？Do you have any significant physical health ailments or conditions? *

是 Yes

否 No

如果有，请告知你现在的状况和药物，以及病史及治疗状况。 If so, please give details of your present condition / medication, the condition’s history and treatments *

你现在是否有任何精神方面的疾患，如忧郁、焦虑、歇息底里或其他？ Do you currently have or in the past had any mental health conditions such as depression, panic attacks, hysteria, etc.? *

是 Yes

否 No

如果有，请告知你现在的状况和药物，以及病史及治疗状况。If so, please give details of your present condition / medication, the condition’s history and treatments *

最近3年以来，你是否有饮酒及服用毒品及任何麻醉品？Have you ever used any alcohol, drugs, or any other intoxicants in the past 3 years? *

是 Yes

否 No

如果有，请告知现在及以前的状况，毒品的类型，是否成瘾，及治疗状况。If so, please give details of present and past usage, types, addictions, treatments, etc. *