EBS Support and Mailing List Information
I would like to be associated with Ecumenical Buddhist Society in the following way: (Please check the appropriate payment lines.) Any donation and support is greatly appreciated.

Name: ________________________________________________________________________

Address: ______________________________________________________________________

City, State, Zip: _________________________________________________________________

Phone (home): ___________________  Phone (work): ___________________________________

Email: _________________________________________________________________________

Support of EBS Operations:

_____   I would like to pledge (payments can me made monthly, quarterly, annually) (Please circle amount.)
        ____$10 per month ____$25 per month  ____$50 per month      Other $_______per_______

_____   I would like to make the following one-time donation (Please circle amount.)
        ____$25                 ____$50             ____$100               Other $___________

_____   I would like to remain on the EBS mailing list and enclose $20 to cover that cost

_____   I cannot contribute at this time, but would like to remain on the mailing list, and will contribute when

             I am financially able to do so.

_____ I would like to receive e-mail announcements about upcoming EBS events at my e-mail address:

                    ________________________@ _________________________________

Please make checks out to EBS.     Mail to:   Ecumenical Buddhist Society
                                                                           1015 West 2nd Street
                                                                           Suite 108
                                                                           Little Rock, AR 72201

 For more information on any of the programs, call 501-376-7056 or check the EBS website at ebslr.org