NAME: ________________________________________________________________________ ADDRESS: (Street)___________________________________(City)______________________ (State)____________________(Country)___________________ (Post/Zip Code)____________ TELEPHONE: (Home) (_______)_________________ (Work) (_______)__________________ FACSIMILE: (_______)___________________ Email:_________________________________ URL: __________________________________________ Date of Birth: __________________ Occupation: __________________________________ I wish to become [__] a Member, [__] an Initiated Member of the Biame Network Inc. If already initiated: I was initiated on ____/____/199___, by: [__] Ken, [__] Elizabeth, I enclose my membership fee of A$60.00. You may pay by credit card using the Payment Authority below. We recommend that you use fax, ordinarymail, or telephone to get this information to us, as we cannot yet guarantee the security of Email. Payment by cheque, money order, or bank draft must be in Australian dollars and made payable toBiame Network Inc. Personal cheques drawn on non-Australian banks are not accepted. The total amount I have enclosed is A$______.00 CREDIT CARD AUTHORITY Credit Card Number: N.B.: You can make your Membership Fee and/or Training Fee payments automatically each year by credit card. To do this, fill in the Automatic Fee Payment Form. You save A$5.00 per fee by doing this.. After submitting this form, you can return to this page to obtain a copy of the Vedic Mantra recording from our Shop. Using this recording initiates you into this Mantra and makes you eligible for Initiated Membership of the Network. Click Here to go to the Shop.
Telephone: 1800 244 254 (Freecall in Australia); +61 3 5799 1198 (International) Facsimile: +61 3 5799 1132 Email: biamenet@eck.net.au Website - http://www.biamenetwork.net |