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 Membership Application for Organization

    Name of the organization*

    Executive Director or Organizational Leader*

    Address*

    City*

    Province*

    Postal Code

    Tel-Cell*

    Email*

    Organizational Point of Contact*
    (This individual will receive communications regarding Representative appointments, invoices, etc.)

    Full Name*

    Title*

    Address*

    City*

    Province*

    Postal Code

    Tel-Cell*

    Email*

    Individual who will serve as Representative on the NBCC International Board of Trustees
    (This is a three year appointment. Representatives are expected to attend Board meetings.)

    Full Name*

    Title*

    Address*

    City*

    Province*

    Postal Code

    Tel-Cell*

    Email*

    Subject

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    Your Message

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    I read the prospectus of National Bangladesh-Canadian Council (NBCC) and understood the contents of prospectus. I accept the responsibilities as a member of NBCC. The above information about our organization or association are true and correct.