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Buddhas’ Practice Incorporated Membership/Renewal Application Form |
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| All prospective members of Buddhas’ Practice Incorporated are required to complete this registration form. Indicate any changes; Membership runs from 1st July – 30th June. 【 】New Membership 【 】Renewal Information 【 】Update |
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| Both my intention and practice are based on Buddhas’ Practice. On this journey, I set forth with Kindness, Compassion, Joy and Giving. Accordingly, I__________ , swear to join this Association and keep all its rules and regulations with a will. Taking full advantage of mutual encouraging, inspiring and supervising, I strive to accomplish the Buddha Path swiftly. |
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| PART A: MEMBER CONTACT INFORMATION | |||
| Title: | 【 】Mr 【 】Mrs 【 】Miss 【 】Ms 【 】Dr Other________ | ||
| Name: | |||
| Date of Birth: | |||
| Address: | |||
| Address 2: |
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| Town/City: | Telephone: | ||
| Country: | Mobile: | ||
| Job Title : | Email: | ||
| Please note that the phone number and email will be listed in the Buddhas’ Practice Incorporated’s directory. | |||
| PART B: MEMBERSHIP TYPE AND PAYMENT DETAILS | |||
| Member Type | Description | Annual Fees | Please Tick |
| Full | Full Membership | AUD 108 | 【 】 |
| Student/Retired | Full-time students and Retired Members | AUD 54 | 【 】 |
| Payment Method | Online Payment 【 】 | Personal Check【 】 | |
| PART C: MEMBER INFORMATION AND PERMISSION TO USE PHOTOGRAPHIC IMAGES: | |||
| Would you like to receive Buddhas’ Practice Incorporated membership information? | Yes【 】 |
No【 】 | |
| Photographs of Buddhas’ Practice Incorporated members may be used in various communications including the newsletter and website. Group photographs taken at Buddhas’ Practice Incorporated events may be used without identifying individual members. For individual photographs, please indicate your permission for use: 【 】Buddhas’ Practice Incorporated has my permission to use and identify photographs of me. 【 】Buddhas’ Practice Incorporated does not have permission to use and identify photographs of me. 【 】Buddhas’ Practice Incorporated must contact me before using any identified photographs of me in its communications. |
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| Online Payment: | Check: | ||
| Bank Name: National Australia Bank | If you use check to pay, please send the check to below: 110/12 Salonika Street, Parap, NT, 0820 |
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| Account: 713 692 270 | |||
| BSB: 085 928 | |||
| SWIFT/BIC: NATAAU3305A | |||
| Account Holder: Buddhas’ Practice Incorporated | |||
| Bank Address: Casuarina Shopping Centre, GD202, 247 Trower Road, Casuarina NT 0810 | |||
| After the application form signed by the person and proposer person, please ensure to send a copy of this Form to: general@bpi2019.org.au | |||
| Applicant Signature: |
Signature of Proposer: |
Signature of Committee Member or Preacher: | |
| Submitting Date: | |||
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