Membership Level change You have selected the Family (Person + Spouse) membership level. This is for family membership (you and your spouse) The cost is $25 per membership term The price for membership is $25.00 per Year. Account Information Already have an account? Log in here Username Password Confirm Password Hint: The password should be at least twelve characters long. To make it stronger, use upper and lower case letters, numbers, and symbols like ! " ? $ % ^ & ). First Name Last Name Email Address Confirm Email Address Spouse First Name Spouse Last Name Spouse Telephone Spouse Email Full Name LEAVE THIS BLANK More Information Address Line 1 Address Line 2 City State Connecticut Massachusetts Maine New Hampshire Rhode Island Vermont Zip Code Phone Number Note: A Paid BANE Membership Entitles You (and Your Spouse, In Case Of A Family Membership) To Vote In Biennial Election/Selection Of Executive Committee Members And Other Referendums Of Changes To The BANE Constitution. Membership Fee Must Be Submitted For Each 2-year Term. Please Read The Below Statement To Ensure You Meet The Requirements To Be A BANE Member. I/We hereby apply for New/Renewal/Life membership of BANE I am/We are at least 18 years of age I am/We are legal resident(s) of New England I am/We are of Bangladeshi origin or heritage I confirm that all the information provided on this form is accurate and that by entering my/our full name(s) below, we are consenting to digitally signing this BANE membership application as if I/we am/are signing the document in writing. Applicant/Member Signature (Full Name) Spouse Signature (Full Name) Payment Information We accept all major credit cards Card Number Expiration Date CVC Processing...
