Life Membership – Vipassana Buddhist Monastery

Life Membership Declaration

NB; By filling this application you would authorise Vipassana Buddhist Monastery Inc to access your given details only for banking, Immigrational or other legal documents without your further consent…

Main Devotee *

Given Name *

Surname *

Date of Birth

Email *

Mobile *

Home

Address

Suburb

State

Postal code

Family members

Title

Name

Date of Birth

Phone

Title

Name

Date of Birth

Phone

Title

Name

Date of Birth

Phone

Title

Name

Date of Birth

Phone

Title

Name

Date of Birth

Phone

I hereby declare that all details provided are true and correct to the best of my knowledge. Also, I will support and actively contribute to the vision of Vipassana Buddhist Monastery.

Vipassana Buddhist Monastery would not consider whether you are a member or not when your services are offered. Our services are open for everyone who needs our generous support.

Vipassana Buddhist Monastery is being operated and maintained by donations. Your monetary donations could be made on the following account.

Account Name	Bank Name	BSB CODE	Acc No
Vipassana Buddhist Monastery Inc.	Commonwealth Bank	BSB 063-241	1091 6037

Account Name	Vipassana Buddhist Monastery Inc.
Bank Name	Commonwealth Bank
BSB CODE	BSB 063-241
Acc No	1091 6037

If you wish to make a monthly direct debit, please mention the amount here. (AUD)