Membership Application

*Name:
*Address:
*City:
*Province:
*Postal Code:
*Email:
*Password:	must contains one digit from 0-9 must contains one lowercase character must contains one uppercase character must contains at least one special character length at least 6 characters and maximum of 20
*Repeat Password:
*Home #:
Cell #:
Other Members of the Household (if applicable)







	Yes, I / We agree to print my name, my spouse’s name, house address and phone number in any BAC publications.
	Type the code from the image

By clicking on the submit I/We hereby confirm that I/ We shall abide by the rules, regulations and By-Laws of the Bengali Association of Calgary (BAC).
* Required fields