Membership

Your Name

First

Last

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

AGE FEE MEMBERS

Phone

SPOUSE (IF APPLYING FOR A FAMILY MEMBERSHIP):

Spouse Name

First

Last

Phone

CHILDREN:

Name

BIRTH DATE (MM/DD/YYYY)

GENDER (M/F)

TWO MEMBERS IN GOOD STANDING AS REFERENCES REQUIRED. IF NOT PROVIDED, AN INTERVIEW WITH EXECUTIVE COMMITTEE IS REQUIRED

REFERENCES:

Name

Phone

DECLARATIONS:

A MUSLIM SHIA ISNA ASHERI OVER THE AGE OF 18

A CITIZEN OF CANADA OR A PERMANENT RESIDENT OF CANADA (All members are required to provide proof of permanent Residency Card, Citizenship Card, or Passport)

RESIDE IN HAMILTON OR ITS ADJOINING AREAS AS DESCRIBED IN THE SOCIETY'S CONSTITUTION (New members are required to provide proof, such as an Ontario Driver's License and/or Health Card)

I HAVE READ THE FORM AND AGREE TO ALL THE TERMS AND CONDITIONS STATED IN IT.

APPLYING FOR THE FOLLOWING MEMBERSHIP: (PLEASE MARK THE APPROPRIATE MEMBERSHIP)

FAMILY

FAMILY

Membership Fee: $600/YEAR (CAN BE PAID IN 12 MONTHLY INSTALLMENTS OF $50.00 PER MONTH)

SELECT OPTION

$600 (YEARLY)
$50 (MONTHLY)

BUILDING FUND: I AM WILLING TO CONTRIBUTE BUILDING FUND (OPTIONAL)

AMOUNT FOR MAINTENANCE FEE

IF UNABLE TO CONTRIBUTE REQUIRED MEMBERSHIP FEE

IF UNABLE TO CONTRIBUTE REQUIRED MEMBERSHIP FEE

PLEASE INDICATE THE AMOUNT YOU ARE ABLE TO CONTRIBUTE:

AMOUNT OF CONTRIBUTION WITHOUT MEMBERSHIP

OPTIONAL CONTRIBUTIONS CAN BE MADE FOR RAMAZAN, MUHARRAM, OTHER EVENTS)

AMOUNT FOR RAMAZAN, MUHARRAM, OTHER EVENTS

NOTE:

ANY WAIVING/REDUCTION OF FEES REQUIRES A WRITTEN REQUEST EXPLAINING FINANCIAL SITUATION AND PROOF OF VOLUNTEER WORK FOR THE COMMUNITY, WAIVING/REDUCTION OF FEES SUBJECT TO EXECUTIVE COMMITTEE'S APPROVAL.

APPLICANT SIGNATURE

Clear Signature

DATE

NOTE:

ALL APPLICATIONS ARE SUBJECT TO EXECUTIVE COMMITTEE/BOARD APPROVAL.
THE MAINTENANCE FEE CAN BE PAID YEARLY OR THROUGH 12 MONTHLY PAYMENTS.
MEMBERSHIPS: MEMBERSHIP FEE MUST BE PAID BY CERTIFIED CHEQUE, BANK DRAFT, MONEY ORDER OR CASH.
AUTHORIZED PAYMENT CAN BE USED TO AUTHORIZE BUTURAB SOCIETY TO AUTOMATICALLY DEDUCT THE MEMBERSHIP/MAINTENANCE FEE YEARLY.
MONTHLY AS INDICATED BY THE MEMBER CONCERNED.
PROOF OF ONTARIO RESIDENCY AND PROOF OF CANADIAN CITIZENSHIP/PERMANENT RESIDENCY MUST BE SHOWN TO A BOARD MEMBER/EXECUTIVE 
COMMITTEE OFFICE BEARER OR ATTACHED TO THIS APPLICATION.

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Buturab Society of Hamilton Inc.

SPOUSE (IF APPLYING FOR A FAMILY MEMBERSHIP):

CHILDREN:

TWO MEMBERS IN GOOD STANDING AS REFERENCES REQUIRED. IF NOT PROVIDED, AN INTERVIEW WITH EXECUTIVE COMMITTEE IS REQUIRED

REFERENCES:

DECLARATIONS:

APPLYING FOR THE FOLLOWING MEMBERSHIP: (PLEASE MARK THE APPROPRIATE MEMBERSHIP)

Membership Fee: $600/YEAR (CAN BE PAID IN 12 MONTHLY INSTALLMENTS OF $50.00 PER MONTH)

BUILDING FUND: I AM WILLING TO CONTRIBUTE BUILDING FUND (OPTIONAL)

PLEASE INDICATE THE AMOUNT YOU ARE ABLE TO CONTRIBUTE:

OPTIONAL CONTRIBUTIONS CAN BE MADE FOR RAMAZAN, MUHARRAM, OTHER EVENTS)

NOTE:

NOTE: