Membership Payment – Hayagriva Buddhist Centre

Name *

First

Last

Email Address *

Please type your email address carefully.

Phone Number *

New or Renewal *

New
Renewal

Tick the checkbox that relates to this application. For “renewals” we will update our records as needed.

Type of Membership *

Individual
Family
Concession

“Concession” is for age pension, disability pension or full-time student,

Concession *

No Concession
Age Pension
Disability Pension
Full-time Student

For a “Concession” membership tick the checkbox for the applicable type of concession. Proof of eligible concession needs to be sighted and should be brought to the centre and presented to our volunteer “welcome” staff on your next visit.

Special Notes (optional)

In the field called “Special Notes” you can enter any notes you want to bring to the attention of to the Membership Co-ordinator. For “Family” membership, you should enter a list of names of those in the family.

Membership Amount Payable

Payment Method *

Bank Transfer
Credit Card
Visit the Centre

To keep our costs to a minimium, our payment preference is by bank transfer. BSB 302-162 Account Number 1922572 Account Name is Hayagriva Buddhist Centre. Please use your surname and initials in reference field.

Credit Card Details

Agree to Conditions of Membership *

I agree to abide by the Conditions of Membership

△ Tick the checkbox on the left above to indicate your agreement to abide by the “Conditions of Membership”.

Click here to View Conditions of Membership Click here to View Gompa Etiquette