| E-mail address: | |
| First Name: | |
| Last Name: | |
| Address1 | |
| Address2 | |
| Town/City | |
| State/Province | |
| Country | |
| ZIP/Postal Code | |
| Phone | |
| Fax |
| Type of Payment Payment can be made by Western Union Online (from U.S. only) or from your nearest Western Union agency (worldwide), or the other methods described opposite in favour of:Jampa Jamling Rimpoche, High Lama of the Upper Dragon Order of the KagyuPa Lineage,Tashi Choeling Monastery, McLeod Ganj, Dharamsala, Dist. Kangra, H.P., India-176219 |
Western Union Online Transfer Western Union Money Wire Order International Money Order Indian Postal Order/Rupee Cheque |
| Western Union Transfer I.D. Code Number (as quoted on Western Union's Money Transfer Website) |
|
| Name as it appears on Western Union Money Transfer Order | |
| Date of Transfer (MM-YY) |
Comments:
|