MEMBER APPLICATION

Membership Application

Part-I Administrative Information
Gender
At which level would you like to join?
Who is the membership for?
Dues are payable annually on March 1 and September 1 or monthly. Members paying by check must either pay annually or semi-annually. Please select from one of the below payment options:
Please select frequency (paying by check MUST select annually or semi-annually)
Part-II Administrative Information

All new members are requested to schedule dokusan (an interview) with the Abbot of the Zen Center, Kwong-roshi.
The following questions are to introduce you to Kwong-roshi so that he knows a little about your personal history,
your life experience, and your spiritual direction prior to your interview. Complete each question and return the
application to the SMZC office, along with your membership dues. All information is kept confidential.

Relationship status
Do you live with this family?
How is your physical health?
How is your mental health?
Do you have any specific health needs, mental and/or physical disabilities?
Do you have any previous meditation or religious practice?

6367 Sonoma Mountain Road, Santa Rosa CA 95404