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Membership application form (Regular member)

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Membership application form (Regular member)

Application date/ / *

Dear Chairman of Nonprofit Organization FAITH

I agree with the purpose and business content of Nonprofit Organization FAITH, and apply for membership.

Membership type	Admission fee
Regular member(Individual and Organization)	5,000yen

Membership type （Please select）	Annual fee	Unit of application	Contents
Individual member	10,000yen/year	Unit*	Individuals who agree to the purpose of this corporation, andparticipate in the operation. Members have voting rights at the General Assembly.
Organization member	10,000yen/year	Unit*	Organizations who agree to the purpose of this corporation, andparticipate in the operation. Members have voting rights at the General Assembly.

Transfer destination bank	Account number	Account holder
多摩信用金庫八王子四谷支店 (Tama Shinkin Bank Hachioji-Yotsuya branch)	0549619	特定非営利活動法人FAITH トクヒ）フェイス

【Member information of Individual】

Full name	*
Date of birth	/ /
Address	Zip code
Phone number	*
FAX
EMAIL	*
URL
Desired activity area

【Member information of Organization】

Organization name	*
Address	Zip code
Phone number	*
FAX
EMAIL	*
URL
Desired activity area

1) Based on the Personal Information Protection Law, we will not provide personal information to third parties, without the consent of the person.
2) The due date of the membership fee is until the end of the membership fee delivery (end of March).
3) Membership will automatically continue if there is no request for withdrawal within the expiration date.
4) Please note that the membership fee once paid can not be refunded.

Nonprofit Organization FAITH
〒193-0816 147-11 Dairakuji-machi Hachioji-shi Tokyo

Please be sure to fill in the fields marked with *.