"Friend" Membership Application

If you would like to become a Member of Atisha Centre ~ LEVEL 1 ~ FRIEND , please
[1]  Complete the form below and  [2] Make payment

[1] Please complete this form

    Your first name:

    Your last name:

    Your email:

    Your telephone number:

    Your address (please include postcode):

    Your birthday:


    I would like to apply for:

    Family Memberships only ~
    Please list the names of family members to be linked to your membership:

    I have the following skills and may be interested in volunteering at the Centre:


    ~ Other (please specify):

    Do you wish to apply for the concessionary rate?
    ~ Please note: Concession is available subject to a Pension or Health Care Card


    Do you wish to apply to be a voting Member at the Atisha Centre AGM?

    If you answered "Yes" to applying to be a voting Member, you are required to supply 2 referees who must be current Members of Atisha Centre:


    * I declare that I am committed to the vision, values and goals of Atisha Centre and the FPMT and the Spiritual Director, Kyabje Lama Thubten Zopa Rinpoche.
    * I adopt the attitude of universal responsibility as taught by His Holiness the Dalai Lama and accept and understand Atisha Centre's affiliation with FPMT.
    * I do not practise Shugden. (If you do not know what this is, you can safely tick the box).

    ***Click to accept this understanding:

    Please note: Acceptance as a voting member of Atisha Centre is subject to Board approval.
    Once the Board has approved of your membership voting rights, you will be notified. There is no extra fee payable!

    [2] Please select below for payment

    Logo: FPMT