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Donate to PAN via PayPal

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Please use the form below to apply to become a PAN Friendly Business (PFB). An * denotes manditory fields or sections.

Please be aware that some of our payment options are seperate to this form, however we do have a PayPal option which will enable you to sign up completely online.

Membership Type *

Membership Period *

Personal Details



(Member number only applicable if you are renewing or are a PAN member converting your membership to a PFB membership, otherwise leave it blank)
May PAN contact you via e-mail?
(PAN's privacy policy is available on our website or can be mailed to you by request)
Type of Business

Please enter the type of Business you are running.

By completing my application to become a member of PAN I assert the following *

  • I wish to become a member of Pagan Awareness Network Inc. (PAN) and support the aims of providing information about Paganism and networking within the Pagan community.
  • I understand that by joining PAN. I agree to abide by the laws and by-laws of the association (available on request).
  • My Business agrees to give a minimum 5% discount to PAN members displaying their membership card at time of purchase.
  • I am over the age of 18.

Payment Details *

as a
When you press the "Submit" button below you will be taken to the secure PayPal website to pay for your registration. Please ensure you continue through to the checkout.
Please mail us your cheque seperately and we will match your payment to your application
Please mail us your money order seperately and we will match your payment to your application
When you press the "Submit" button below you will be taken to our online credit card partners PayPal via the secure PayPal website to pay for your registration. Please ensure you continue through to the checkout.

Please list your direct deposit reference if you used one and we will match your payment to your application

Anti-Spambot Verification

Enter Verification Code *
 
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Direct Deposit Details

If you are paying your membership fee by direct deposit please use the details below.

Bank: Westpac Banking Corporation
   Acc Name: Pagan Awareness Network Inc.
   BSB: 032206
   Acc Number: 167670