Please register before March 31. E-mail or fax the following information to
E-mail: siddwish@hello.com.tw
Fax: (+886-2) 89193833

Once we have received your registration details, we will send you further information in English and Chinese* regarding how to get to the retreat center. (*If your computer cannot decode Chinese characters, please supply us with a fax number.)

Name(s):
_______________________________________________M:[ ] F:[ ]
Address:
_______________________________________________________

_______________________________________________________
Tel:
_______________________________________________________
Fax including country and area codes:
_______________________________________________________
Email:
_______________________________________________________

My computer can [ ] / cannot [ ] decode Chinese characters.

Passport number (for insurance purposses):
_______________________________________________________

I plan to attend the following empowerment/retreat:
April 20-22 Black Jambhala empowerment and retreat [ ]
April 27-29 Manjushri empowerment and retreat [ ]

I required accommodation on the following days:
April 20 [ ], April 21 [ ]
April 27 [ ], April 28 [ ]

If you plan to arrive early and/or leave late, please specify the dates you require accommodation: April ________ to April ________

I require a double room [ ]
Please state name of partner:___________________________

I require a bed in a twin room [ ]