Membership Application

*Name:		required required
*Address:		required
*City:		required
*Province:		required
*Postal Code:		required
*Email:		required invalid format
*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	required invalid format
*Repeat Password:		required
*Home #:		required
Cell #:
Other Members of the Household (if applicable)
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	Yes, I / We agree to print my name, my spouse’s name, house address and phone number in any BAC publications.
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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).
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