Membership Application Form

Nepalese Canadian Heritage Centre
7955 Torbram Road, Unit #21, Brampton, ON L6T 5B9
Business No: 80143 2501
I ,
would like to apply for the membership of the Nepalese Canadian Heritage Centre.
Address
Tel
Email
Membership fee received: $
Type of membership:
Membership expiry date:
Date Format: MM slash DD slash YYYY
Area of expertise, if any:
I shall abide by provision of the articles, by-laws and written policies of Nepalese Canadian Heritage Centre.
Consent
- I give consent to make my name and contribution to NCHC public.
- I do not give consent to make my name and contribution to NCHC public.
Signature of Applicant*
E-signature Policy*
I agree by signing e-signature, I hereby treat this as legal signature
For Official Use Only
Date of submission to board for approval:
Date Format: MM slash DD slash YYYY
Date approved:
Date Format: MM slash DD slash YYYY
Signature of approving officer:

For Official Use Only