ISLAMIC ASSOCIATION OF
CANADIAN WOMEN
MEMBERSHIP APPLICATION
FORM
APPLICANT’S DETAILS
Legal name:
____________________________________________________________________
Address:
_______________________________________________________________________
Postal code:
____________________________________________________________________
Home phone:
___________________________________________________________________
Cell phone:
_____________________________________________________________________
Work phone:
___________________________________________________________________
Email
address: __________________________________________________________________
Alternate
email address: __________________________________________________________
Preferred
method to contact: ______________________________________________________
MEMBERSHIP FEES: $10 PER MONTH
Please tick the method of payment: Cash Debit card Credit card
AGREEMENT
I,
__________________________________, apply to become the member of Islamic Association
of Canadian Women.
I,
__________________________________, declare that I am a legal and law abiding
resident/ citizen of Canada.
In case of minors (less than 18 years old): Parent’s
signature: ____________________ Full
name: ___________________________ Date:
_______________________________
I,
__________________________________, understand that membership will continue
until terminated by either party.
Signature:
_________________________
Full name:
_________________________
Date:
_____________________________
NOTE: Confirmation
of your acceptance as a member will be sent within 28 days.
DATA PROTECTION NOTICE
Information
provided by you on this form will be processed by the IACW and used solely for
communications with you regarding matters relating to your membership of IACW.
Your details will not be passed to third party organizations without your
consent.