Home
Phenomenal Woman Award
Join!
About
Contact

Membership Application FormDad2021-07-04T09:54:13-03:00

Membership Application Form

IMPORTANT

Paying by PayPal:

fill out and submit this form
at the bottom of the page under “Paying With PayPal”, select your membership fee
click on the PayPal Subscribe Button

Please fill out our Application Form

I hereby apply for (please select):*

New Membership

Membership Renewal

If applying as a new member, how did you hear about BPW Greater Moncton?*

First Name*

Last Name*

Home Address*

City*

Province*

Postal Code*

Home Phone

Cell Phone

Email Address*

Please select which ones apply to you*

Business

Employer

School

Job Title

Address

City

Province

Postal Code

*Student applications will not be accepted without the name and address of the institution.

Have you previously been a member of BPW?*

Yes

If Yes, when and where?

Type of membership requested (select one)

ACTIVE MEMBER

ASSOCIATE MEMBER

STUDENT MEMBER

HONORARY MEMBER

Active Member - A woman who, at time of admittance to the Club, is engaged in remunerative employment.
Associate Member - A woman who, at the time of admittance to the Club is not engaged in remunerative employment.
Student member - A woman enrolled in 60% full time or more study at a post-secondary educational institution.
Honorary Member - A woman of special merit, voted an Honorary Member by the Club (includes Lifetime Members).

If you selected "Active Member" please select one of the following:

I am a YOUNG BPW (35 and under)

I am 65 years of age or older

Not applicable

What is your date of birth? (y/m/d)*

I consent to sharing my name, workplace and photographs taken at Club meetings and events for Club promotional purposes on social media including, but not limited to BPW website and Facebook*

Yes

I consent to being added to the email distribution list of the Club*

Yes

Membership Fees (Select the one that applys to you)*

Active or Associate Member: $125.00

Senior Member: $90.00

Student Member: $90.00

Hororary or Lifetime Member: No Charge

Payment Options*

Download Application Form and Mail in Fee

PayPal

Download Application Form Here

If paying by PayPal: 1) fill out and submit this form. 2.) at the bottom of the page under "Paying With PayPal", select your membership fee 3.) click on the PayPal Subscribe Button

I have read and agree to the Code of Conduct*

Yes

To prevent spam please type the characters*

This field should be left blank

Paying with PayPal

Select the appropriate membership fee and click on the Subscribe button.

Membership Fees

Paying by Cheque

Please make cheque payable to:

BPW Greater Moncton

Mail application form and payment to:
BPW Greater Moncton
RPO North End, Box 29162
Moncton, NB E1G 4R3

Our meetings are on the first
Wednesday of each month.

info@bpwmoncton.com

Inquire Here

First Name*

Last Name*

Email Address*

Phone Number*

Let us know how we can help*

This field should be left blank