BPW Barrie Membership Application/Renewal

Business and Professional Women (BPW) Barrie

MEMBERSHIP APPLICATION

Name*

Address: (Street, City, Postal Code)*

Cell Phone

Other Phone

Email Address*

example@example.com

Occupation/Profession*

PLEASE SELECT ALL OPTIONS BELOW THAT APPLY:

I am a new BPW Barrie member, ORI am a renewing BPW Barrie memberI will pay the membership fee* via eTransfer (to: treasurer@bpwbarrie.com), ORI will pay the membership fee* via cash, cheque or debit, ORI will pay the membership fee* via credit card ($5.00 administration fee applies)I request a BPW Barrie magnetic name tag (add $15 to membership fee*)I am a full-time student (reduced membership fee* applies)I am a Young BPW Member (35 years old or under)

*MEMBERSHIP FEE: $175 ($125 for full-time students)

Please note that by signing this application, you consent to the following:

I hereby declare that all information contained in this form is true.

I hereby agree to support BPW's mandate to develop the business, professional and leadership potential of people who identify as women.

I hereby agree to review and follow BPW by-laws.

I hereby give consent to BPW to use and/or share my name, image, or voice for the purpose of promoting BPW and/or providing benefits of membership.

I hereby give consent to BPW to share my personal contact information with other BPW members strictly for the purposes described above.

I hereby agree to protect all BPW members' personal information from distribution outside of BPW for commercial use.

I hereby give consent to receive email communications from all levels of BPW (Barrie, Ontario, Canada, and International), but further understand that permission may be revoked at any time by using the unsubscribe link at the bottom of every email.

I understand that the BPW membership year is from May 1 to April 30 and agree that I must renew my membership each year on or before May 1 to remain a member in good standing.

Applicant Signature*

Date*

CONTACT US AT: bpwbarrie@bpwbarrie.com