If you would like to become a Member of Atisha Centre ~ LEVEL 1 ~ FRIEND , please[1] Complete the form below and [2] Make payment
[1] Please complete this form
Your first name:
Your last name:
Your email:
Your telephone number:
Your address (please include postcode):
Your birthday:
Day:
—Please choose an option—12345678910111213141516171819202122232425262728293031
Month:
—Please choose an option—JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember
I would like to apply for:
Single Friend MembershipFamily Friend Membership
Family Memberships only ~
Please list the names of family members to be linked to your membership:
I have the following skills and may be interested in volunteering at the Centre:
AdministrationLegalBuilding/MaintenanceRetail/BusinessCateringGardeningEducationComputer/TechnicalPublicationCleaning
~ Other (please specify):
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Do you wish to apply for the concessionary rate?
~ Please note: Concession is available subject to a Pension or Health Care Card
NoYes
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Do you wish to apply to be a voting Member at the Atisha Centre AGM?
NoYes
If you answered "Yes" to applying to be a voting Member, you are required to supply 2 referees who must be current Members of Atisha Centre:
REFEREE No.1 - Name + Phone or Email:
REFEREE No.2 - Name + Phone or Email:
__________________________________________________________________________________________________________
* I declare that I am committed to the vision, values and goals of Atisha Centre and the FPMT and the Spiritual Director, Kyabje Lama Thubten Zopa Rinpoche.
* I adopt the attitude of universal responsibility as taught by His Holiness the Dalai Lama and accept and understand Atisha Centre's affiliation with FPMT.
* I do not practise Shugden. (If you do not know what this is, you can safely tick the box).
***Click to accept this understanding:
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Please note: Acceptance as a voting member of Atisha Centre is subject to Board approval.
Once the Board has approved of your membership voting rights, you will be notified. There is no extra fee payable!