Update Membership Form

New Membership Form

Use this form to apply for new membership with us
Personal Details:
Title
First Name
Surname
Street Address
Suburb
State
Post Code
Phone Number
Format: 0000 000 000.
E-mail
example@example.com
Date of Birth

DayMonthYear
Gender
Status
Please Note:

Single person(s) are those 25 years of age and over.
Are you a member of any other Burial Fund
Spouse Details
Spouse Title
Spouse First Name
Spouse Surname
Spouse Date of Birth

DayMonthYear
Spouse Gender
Spouse Phone Number
Format: 0000 000 000.
Spouse E-mail
example@example.com
List All dependants under the age of 25 living at home
Please Note
- Benefits will commence two (2) years after joining.
- Transportation of the Deceased will incur additional cost if the distance travelled is more than 200 km.
- You need to pay joining fee prior to lodging this application.
- Please make Cheque or Money Order payable to the Muslim Burial Society of Perth
- Please do not sent cash in the mail, our Bank details are as follows:
Bank: Commonwealth Bank

Branch: Malaga

Account Name: Muslim Burial Society of Perth

BSB: 066-167

Account Number: 10627866

Reference: Your Name/Membership Number
Privacy Statement

The personal information we collect about you is necessary in assisting us to manage your Burial details. Your personal information will not be used or disclosed for any other purpose without your prior consent, except where required by law.
I consent the use of my email address and mobile number to receive regular member updates/funeral notices from the Muslim Burial Society of Perth.
I would like to pay my membership fees
Please verify that you are human
Any queries please contact us at info@mbsperth.org
Should be Empty:

New Membership Form

Personal Details:

Spouse Details

List All dependants under the age of 25 living at home

Please Note

Privacy Statement