THE HSWAGATA BUDDHA TOOTH RELIC PRESERVATION MUSEUM
FOR INTERNAL USE ONLY
Template No.: T176
Template Title: Lay Donor Registration & Contact Form
Related Research Case IDs / Cluster: Cluster D (Everyday Faith & Lay Donations), Cases 36–45
Linked Templates / Policies: Donation Handling Policy, Data/Privacy Rules, T165 (Internal Memo), T170 (Compliance Self-Check), T173 (Records Classification)
Date of form: ____ / ____ / ______
Prepared by / Role: _______________________
Office / Unit: ____________________________
Country / Location: _______________________
Confidentiality Level:
Internal only [ ] Restricted [ ] Sacred-Restricted / Sensitive [ ]
Use of this form (tick):
New case / action [ ] Follow-up [ ] Annual review [ ] Archive only [ ]
1) Purpose (why we use this form)
This form records lay donor details in a respectful way.
It helps communication, gratitude, and community connection, with clear consent.
2) Donor identity (name)
Full name (as preferred): __________________________________________
Title (Mr/Ms/Mrs/Ven./Dr./Other): _________________________________
Nickname (optional): ______________________________________________
Date of birth (optional): ____ / ____ / ______
National ID / passport (optional, only if required): ___________________
3) Contact details (contact)
Primary contact
Phone: __________________________
Email: __________________________
Address (optional): _______________________________________________
City/Province: __________________ Country: _______________________
Alternative contact (optional)
Phone / email: _________________________________________________
Preferred contact method (tick): Phone [ ] Email [ ] SMS [ ] Messaging app [ ] Letter [ ] In-person [ ]
4) Link to community (community connection)
Tick all that apply and add details.
Local community member near HSWAGATA [ ] Details: __________________
Member of a temple community [ ] Temple name/location: ______________
Village / district link [ ] Village name: ____________________________
Supporter of a village stupa project [ ] Project name/location: _______
Family / group donor (donation made as a group) [ ] Group name: ______
Introduced by another donor [ ] Name (if allowed): __________________
Other community link: __________________________ [ ] Details: ________
5) Donor interests (optional but helpful)
Main interests (tick): Relic education [ ] Village stupa support [ ] Community events [ ] Preservation/conservation [ ] Youth/learning [ ] Other: ____
Notes (simple): ___________________________________________________
6) Consent for contact (required)
A) Consent statement (tick one):
I agree that HSWAGATA may contact me about museum activities, thanks/receipts (if relevant), and community programs.
Yes [ ] No [ ]
B) What can we contact you about? (tick all that apply)
Receipts / donation confirmation [ ]
Thank-you message [ ]
Museum news and events [ ]
Volunteer opportunities [ ]
Community/village stupa projects [ ]
Urgent notices (only if needed) [ ]
C) Channels allowed (tick):
Phone call [ ] Email [ ] SMS [ ] Messaging app [ ] Letter [ ]
D) Frequency preference (tick):
Only when needed [ ] Monthly [ ] Quarterly [ ] Yearly [ ]
E) Consent date: ____ / ____ / ______
F) Donor signature (or thumbprint): _______________________________
If consent is No, record reason (optional): _________________________
7) Data protection note (internal)
This record is for museum use only.
Do not share donor details outside the museum without approval.
If a donor asks to update or remove contact details, do it promptly.
Classification recommendation (tick): Internal [ ] Restricted [ ]
Reason (if Restricted): ______________________________________________
8) Internal notes (optional)
Relationship notes (keep respectful): _______________________________
Important dates (optional): ________________________________________
Follow-up needed? Yes [ ] No [ ] By when: //____
9) Verification and filing
Recorded by (name/role): _______________________ Signature: __________ Date: //____
Checked by (Unit Head / Admin): ________________ Signature: __________ Date: //____
File code / reference ID: ____________________
File location (cabinet/folder + digital path): __________________________
Retention period: 1 year [ ] 3 years [ ] 5 years [ ] Permanent [ ] Other: ____
