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
Name
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
Events
I am interested in attending: *
Required
Social events I am interested in attending *
Required
Other
What is your preferred communication method with Unibodhi?
How did you find out about Unibodhi? *
Required
Thank you!
CAPTCHA *
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