湖北黄梅四祖寺第二届禅文化夏令营报名问卷
<P align=center TEXT-ALIGN: 0pt; 0cm center><B>禅文化夏令营报名问卷</B><B><p></p></B></P>
<P 0cm 0pt><FONT size=3><I>请认真填写此卷，要求书写工整、内容如实，这是进入夏令营的第一步</I>。</FONT></P>
<P 0cm 0pt TEXT-INDENT: 18.0pt; lfo1 level1 mso-list: list tab-stops: l2 -18pt; 18pt;><B><FONT size=3>1.</FONT> </B><B><FONT size=3>个人简况<p></p></FONT></B></P>
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<P align=center TEXT-ALIGN: 0pt; 0cm center>姓 名<p></p></P></TD>
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<P align=center TEXT-ALIGN: 0pt; 0cm center><p> </p></P></TD>
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<P align=center TEXT-ALIGN: 0pt; 0cm center>性别<p></p></P></TD>
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<P align=center TEXT-ALIGN: 0pt; 0cm center><p> </p></P></TD>
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<P align=center TEXT-ALIGN: 0pt; 0cm center>年 龄<p></p></P></TD>
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<P align=center TEXT-ALIGN: 0pt; 0cm center><p> </p></P></TD>
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<P align=center TEXT-ALIGN: 0pt; 0cm center>民族<p></p></P></TD>
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<P align=center TEXT-ALIGN: 0pt; 0cm center><p> </p></P></TD>
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<P align=center TEXT-ALIGN: 0pt; 0cm center 5.65pt>照 片<p></p></P></TD></TR>
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<P align=center TEXT-ALIGN: 0pt; 0cm center>文化程度<p></p></P></TD>
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<P align=center TEXT-ALIGN: 0pt; 0cm center><p> </p></P></TD>
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<P align=center TEXT-ALIGN: 0pt; 0cm center>婚否<p></p></P></TD>
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<P align=center TEXT-ALIGN: 0pt; 0cm center><p> </p></P></TD>
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<P align=center TEXT-ALIGN: 0pt; 0cm center>联系电话<p></p></P></TD>
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<P align=center TEXT-ALIGN: 0pt; 0cm center><p> </p></P></TD></TR>
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<P align=center TEXT-ALIGN: 0pt; 0cm center>工作或学习单位<p></p></P></TD>
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<P align=center TEXT-ALIGN: 0pt; 0cm center><p> </p></P></TD></TR>
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<P align=center TEXT-ALIGN: 0pt; 0cm center>通讯地址及邮编<p></p></P></TD>
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<P align=center TEXT-ALIGN: 0pt; 0cm center>E-mail<p></p></P></TD>
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<P 0cm 0pt><p><FONT size=3> </FONT></p></P>
<P 0cm 0pt><FONT size=3>请在下面符合您情况的选项后划“√”，并在<U> </U>上填写适当的内容：</FONT></P>
<P 0cm 0pt><FONT size=3><B>2.</B><B>健康状况</B>：</FONT></P>
<P 0cm 0pt 18pt><FONT size=3>a)您目前的身体状况：A.很健康 □ B.一般 □ C.体弱 □ D.疾病中 □</FONT></P>
<P 0cm 0pt 18pt><FONT size=3>b)有无传染病史：A.有 □ B.无 □ ；若有，曾患何病<U> <p></p></U></FONT></P>
<P 0cm 0pt><FONT size=3> c)您在生活上是否需要特殊照顾： A.否 □ B.是 □ ;若需要，请于简述中说明情况。</FONT></P>
<P 0cm 0pt><FONT size=3><B>3.</B><B>学佛经历</B>：</FONT></P>
<P 0cm 0pt TEXT-INDENT: lfo1 mso-list: list tab-stops: l2 level2 45.75pt; -24.75pt;><FONT size=3>a)</FONT> <FONT size=3>您最早接触佛教的时间是<U> <p></p></U></FONT></P>
<P 0cm 0pt TEXT-INDENT: lfo1 mso-list: list tab-stops: l2 level2 45.75pt; -24.75pt;><FONT size=3>b)</FONT> <FONT size=3>用一句话概括您接触佛教的因缘<U> <p></p></U></FONT></P>
<P 0cm 0pt TEXT-INDENT: lfo1 mso-list: list tab-stops: l2 level2 45.75pt; -24.75pt;><FONT size=3>c)</FONT> <FONT size=3>您是否受过皈依： A.是 □ B.否 □ 您受皈依的时间是<U> <p></p></U></FONT></P>
<P 0cm 0pt TEXT-INDENT: lfo1 mso-list: list tab-stops: l2 level2 45.75pt; -24.75pt;><FONT size=3>d)</FONT> <FONT size=3>您受持何种戒法： A.五戒 □ B.菩萨戒 □ C.未受戒 □<U><p></p></U></FONT></P>
<P 0cm 0pt TEXT-INDENT: lfo1 mso-list: list tab-stops: l2 level2 45.75pt; -24.75pt;><FONT size=3>e)</FONT> <FONT size=3>您是否学过打坐： A.是 □ B.否 □<U><p></p></U></FONT></P>
<P 0cm 0pt 45.75pt><FONT size=3>如果学过，那您是否经常打坐：</FONT></P>
<P 0cm 0pt 45.75pt><FONT size=3>A．从不 □ B.偶尔 □ C.经常 □ D.每天 □</FONT></P>
<P 0cm 0pt 45.75pt><FONT size=3>您主要的用功方法是<U> <p></p></U></FONT></P>
<P 0cm 0pt 45.75pt><FONT size=3>一般一次坐多长时间<U> <p></p></U></FONT></P>
<P 0pt; 0cm TEXT-INDENT: 2.0 mso-char-indent-count: 21pt;><FONT size=3>f) 您是否经常研读佛教经典: A.从不 □ B.偶尔 □ C.经常□ D.每天 □</FONT></P>
<P 0pt; 0cm TEXT-INDENT: 2.0 mso-char-indent-count: 21pt;><FONT size=3> 请列举几部对您影响较大的经典或佛教书籍<U> <p></p></U></FONT></P>
<P 0pt; 0cm TEXT-INDENT: 2.0 mso-char-indent-count: 21pt;><FONT size=3> <U> <p></p></U></FONT></P>
<P 0pt; 0cm TEXT-INDENT: 2.0 mso-char-indent-count: 21pt;><FONT size=3>g) 您是否参加过生活禅夏令营: A.是 □ B.否 □</FONT></P>
<P 0pt; 0cm TEXT-INDENT: 2.0 mso-char-indent-count: 21pt;><FONT size=3> 如果参加过,请问是第几届:<U> <p></p></U></FONT></P>
<P 0cm 0pt TEXT-INDENT: level1 mso-list: list tab-stops: l0 lfo2 46.5pt; -25.5pt;><FONT size=3>h)</FONT> <FONT size=3>您参加过何种集体修行活动(包括气功)<U> <p></p></U></FONT></P>
<P 0cm 0pt TEXT-INDENT: level1 mso-list: list tab-stops: l0 lfo2 46.5pt; -25.5pt;><FONT size=3>i)</FONT> <FONT size=3>您学佛以后最大的收获是<U> <p></p></U></FONT></P>
<P 0cm 0pt TEXT-INDENT: level1 mso-list: list tab-stops: l0 lfo2 46.5pt; -25.5pt;><FONT size=3>j)</FONT> <FONT size=3>您目前最大的困惑和障碍是<U> <p></p></U></FONT></P>
<P 0cm 0pt 21pt><FONT size=3> <U> <p></p></U></FONT></P>
<P 0cm 0pt 21pt><FONT size=3>k) 您希望得到那些方面的指导<U> <p></p></U></FONT></P>
<P 0cm 0pt 21pt><FONT size=3> <U> <p></p></U></FONT></P>
<P 0cm 0pt TEXT-INDENT: level1 mso-list: list tab-stops: -28.5pt; lfo3 l1 49.5pt;><FONT size=3>i)</FONT> <FONT size=3>如果夏令营期间需要您作义工,您愿意做何种工作<U> <p></p></U></FONT></P>
<P 0cm 0pt><FONT size=3><B>4.</B><B>请简述你的生活背景、学佛过程或对佛教的印象</B>(要求不少于300字,请在背面书写)</FONT></P>
<P 0cm 0pt><p><FONT size=3> </FONT></p></P>
<P 0cm 0pt><FONT size=3><B>联系地址: </B> 湖北黄梅四祖寺客堂 <B> </B><B>邮政编码: </B> 435500 <B> </B><B>联系人:</B> 能证</FONT></P>
<P 0cm 0pt><FONT size=3><B>咨询电话:</B> 0713-3166309 / 3166010 <B>传真:</B> 0713-3166010 <B> </B><B>邮箱: </B> <a href="mailtfx@sizusi.org" target="_blank" ><FONT color=#464646>fx@sizusi.org</FONT></A></FONT></P>
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