August 2000
Smart Card
Declaration and Acknowledgement - Australia
Elan Vital, Inc. USA ('Elan Vital, lnc.') confirms that information submitted on the Smart Card Application Form shall be kept confidential. I acknowledge and agree that:
- l have received the techniques of Knowledge either directly from Maharaji or from an instructor who
was authorised to conduct Knowledge sessions at the time;
- Any Smart Card issued following the submission of this information is and shall remain the property of
Elan Vital, Inc. and is returnable to Elan Vital, Inc. upon request;
- The information and the issue of any Smart Card is for use in facilitating attendance at any event
(convention, conference, seminar etc.) sponsored in whole or in part by Elan Vital, lnc. (without
thereby creating any contractual or other legal right to attend that or any event);
- Elan Vital, lnc. is hereby authorised to transmit this information to any organisation with similar
objectives (a related organisation) or to a service provider on behalf of the related organisation in order
to facilitate the use of the Smart Card for attendance at similar events sponsored in whole or in part by
the related organisation;
- may at any time update or amend the information by writing to or faxing Elan Vital, |nc.:
Email Address: smartcardoffice@attglobal.net
Fax Number: 818 707-6378 (in the USA)
Mailing Address: Smart Card Office, PO Box 2278, Agoura Hills, California USA 91376
(or at the local address below);
- Information given may be subject to verification. Elan Vital, lnc. reserves the right to refuse an
application and the right to cancel a Smart Card after it is issued;
- l may at any time withdraw my authorisation for use of this information by writing to or faxing Elan Vital
Inc. as shown above, whereupon the information will be destroyed; the Smart Card will automatically
be cancelled and will be returnable to Elan Vital, Inc.
Elan Vital lnc, Australia has created a personal data filing system for the purposes of helping the issue of
the Smart Card to individuals and for the updating of mailing lists.
- ln compliance with the regulations in force concerning the protection of individuals regarding the
processing and transfer of personal data, l hereby authorise Elan Vital lnc, Australia to process and
record my personal data using its filing system and to transfer such data to other organisations that
have similar aims to those of the above mentioned organisation, and specifically to Elan Vital, lnc.,
P.O. Box 2278, Agoura Hills, CA 91376, USA.
- I may at any time change, erase or block my data, or request information about my data, by writing to
Elan Vital lnc, Australia at Aus SmartCard Processing, 366 Glen Eira Road, Caulfield Vic 3162.
Signed: _____________________________________ Date:, ______/_____/_________
(Day /Month/ Year)