The Malaysia Singapore Brunei Cultural Association 

#238 2680 Shell Road, Richmond, B.C., Canada, V6X 4C9

  

APPLICATION / RENEWAL FORM

 

Name: ___________________________________________________ (circle one) New/Renewal

Spouse's Name: _______________________________________________________________

Children's Name(under 18 only): __________________________________________________

Address: ____________________________City________________, Postal Code____________

Phone: ________________________ Fax: __________________________

Email: ________________________________ (strictly for MSBCA Correspondence only)

Annual Membership Fee( Jan-Dec):

1                    Single - $20.00: ______________ Cash/Cheque

2                    Family - $30.00: ______________ Cash/Cheque 
            Family - $20.00 (* senior/retiree)    Cash/Cheque
3. Corporate - $160.00: __________ Cash/Cheque

Life Membership Fee- $300.00: ________  Cash/Cheque

Life Membership Fee- $200.00 (*senior/retiree) Cash/Cheque

 

 

 Official: ____________________________,         Date: __________________ (* Seniors defined as 60 years and above)

 

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To: _____________________________, Date: ____________________________(This is your receipt)

 

Thank you for taking the time to fill out this application. MSBCA and the Directors welcome you.  You will  receive a copy of our Newsletter published every 4 months. Also, being a member gives you access to   the premises during business hours and offers you the opportunity to participate in the other activities at  a discount rate.

 

Once again, thank you and WELCOME.

Cash/Cheque Received:____________
Official:_________________________

Yours sincerely,    
Membership Director
Email: msbca@shaw.ca, Website: www.msbca.com Application Form/Oct 2005

Incorporated December 1976