NBIC Membership | Application Form

Revised 12/2023

Please use the application form below to apply for a new NBIC membership. Click submit when completed.
Wait to hear back from the NBIC Membership Team. They will contact you once they have received your application form.
Make your NBIC membership payment through the link provided in your email.
Congratulations! Once this last step is completed, you are officially a member of the NBIC family. Welcome aboard!

Member Information

Name

First Name

Last Name

DOB

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Cell Phone

(###)

###

####

Home Phone

(###)

###

####

Spouse Information (If applicable)

Name

First Name

Last Name

DOB

YYYY

Phone

(###)

###

####

Phone

(###)

###

####

Type of Membership ( 1-year reoccurring)

Membership

In order to create a more dynamic community where all members contribute their time and skills and work cooperatively together, we recommend that all full members contribute 4 hrs of community service monthly, in addition to membership fees below. Full members will have the additional benefit of being able to participate in annual Community meetings. We encourage you to join as full members, participating fully in the community and thus resulting in a more productive, energetic organization.

Additional Information

Do you have any skills or services you would like to offer/promote through NBIC (for example, business, medical services, or any other specialties)? Please list

Anything else you would like to tell us about yourself or what other services you would like to see as part of your membership to NBIC:

I authorize NBIC to share information with MAUN team in the event member decides to sign up for MAUN account

Yes

I understand that the NBIC Board has the right to reject my membership application or to suspend my membership in accordance with the rules and regulations stated in its bylaws.

Spouses Signature

Sign and date below

Member Signature

Sign and date below

Membership to NBIC has its benefits; not only will you be helping support ongoing services NBIC provides the community, but furthermore membership enables you to:

1. Receive the latest information on all upcoming events and programs. 2. Receive discounts on rental hall, classes and special programs. 3. Access to NBIC programming online. 4. Promote your business/services through online advertising and masjid bulletins. 5. Develop an ongoing relationship with NBIC, where we may communicate together and better address the needs of the community.

Your support and feedback is vital. We thank you for joining NBIC and wanting to be a part of the our family.

Office Use Only

Initials: ______________________ Received: ___________________ Approved: ___________________ Date: ________________ Payment made: ___________________ Comments: ____________________________________ Approving Board Member's Signature & Title: _________________________________________________ Renewal Date: _________________________ Initials: _________________________ Comments: ___________________________Renewal Date: ______________ Initials: _________________ Comment: ___________________________