Application

BIAME NETWORK INC. TRAINING PROGRAM

APPLICATION FORM

To join the Training Program conducted by the Biame Network Inc. Incorporated, you need to complete the following steps:

Become an Initiated Member of the Network. (See Membership Application Form in the "Membership & How to Join Directory" in the "General Directory".)
Complete this form.
Pay the necessary fees.
Send the completed application(s) to Biame Network

You have two options for completing this form:

You can apply Online using this form, or

You can Print Another Form Here, that you can then fax, or mail to us.


NAMES
Last Name:     
First Names:  

ADDRESS
Street:        
City:          
State:           
Country:        
Area/Zip Code: 


TELEPHONE AND OTHER CONTACTS
Home:       
Work:     
Fax:      
Mobile:   
Email:    
URL:      

Please fill the section below that applies to you.

  I am already an Initiated Member of the Network:
	  I enclose my Training Fee of A$55.00.
	  I enclose A$10.00 for the first Lesson.
	  I would like to arrange telephone or tape sessions with a trainer.

  I am a Member of the Network, but not an Initiated Member:
	  I wish to order a copy of the Mantra Meditation Tape & enclose A$19.95 for this.
	  I enclose my Training Fee of A$55.00.
	  I enclose A$10.00 for the first Lesson.
	  I would like to arrange telephone or tape sessions with a trainer.

  I am neither a Member nor Initiated Member, 
    and I wish to join the Network as an Initiated Member:
	  I wish to order a copy of the Mantra Meditation Tape & enclose A$19.95 for this.
	  I have filled in the Membership Application Form and sent it with this form.
	  I enclose my Training Fee of A$55.00.
	  I enclose A$10.00 for the first Lesson.
	  I would like to arrange telephone or tape sessions with a trainer.


PAYMENT AUTHORITY

The total amount I have enclosed is A$   

(Please note that you can reduce by A$5.00 each, 
your Membership and Training Fees, when you also complete the 
Automatic Fee Payment Form.  See below.) 


I am paying by  Credit Card


CREDIT CARD AUTHORITY


My credit card is:  

Number:  

Valid from(mm/yyyy):  /    Valid to(mm/yyyy):  /


Date of Completion of this form is:

REMEMBER TO PRINT THIS FORM FOR YOUR RECORDS USING YOUR BROWSER

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..

Produced by Biame Network Inc.,
P.O. Box 271, Seymour,
Victoria 3661, Australia.
Telephone: 1800 244 254
International: +61 3 5799 1198
Facsimile: +61 3 5799 1132
Email: biamenet@eck.net.au
Website: www.biamenetwork.net