2016 UNIBODHI Membership Form
First Name/s *
Your answer
Surname *
Your answer
Preferred Name *
Please write the name you prefer to be addressed by here.
Your answer
Contact details
Email address *
We will mainly communicate to you via emails. Please write the address you wish us to mail to here.
Your answer
Phone number
We may contact you by phone from time to time. If you do not wish for this to happen, do not write your phone number here.
Your answer
Access ID
Do you have a current USU Access card? *
What is your Access ID?
Write the last seven digits of the barcode number below.
Your answer
I am interested in attending: *
Social events I am interested in attending *
What is your preferred communication method with Unibodhi?
How did you find out about Unibodhi? *
Thank you!
In order to ensure this form is being filled by a human, please write in the field below any number that is not between 0 and 300
Your answer
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