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MEMBERSHIP FORM

The Application Form for 2007 Membership
Please complete the entire form, the fields with the () are required.

Name
 :
Profession :
Name of Spouse :
Profession :
Address :
:
City :
State :
Zip Code :
Phone : (Home)     (Work)
: (Mobile)        (other)
Email :
(other)

No. of Children

 :

Names of Children

 : (Please list the names of only unmarried children)
Name: Age: Male Female
Name: Age: Male Female
Name: Age: Male Female
Names of Parents :
(Please list their names, if they are residing at the same address)
Name: Age:
Name: Age:
Type of Membership :
Individual: $11
Family: $21
Additional Donation
 : (optional)
Kindly mail your cheque in the name of 'Jain Sangh of Greater Austin' to Mr. Vishal Jhaveri (address shown below).
Would you like to be added to the JSGA directory?      Yes
The JSGA directory will include a list of all member names, address, phone numbers and email address.
You will also be notified of the upcoming Jain sangh events by email.
 
Jain Sangh of Greater Austin, any sponsors, and/or members of the Jain Sangh of Greater Austin are
not responsible for any damages, loss of personal property, injury of any kind, or any kind of liabilities
resulting from participating in Jain Sangh of Greater Austin programs (on or off site).
  

If you have trouble submitting this information, please click on the download button below and then mail or email the completed form to:

Vishal Jhaveri
15520 Echo Hills Drive, Austin, TX-78717
Email: vishal_jhaveri@hotmail.com
Telephone: 512-310-7160

If you need any assistance, please email info@jainsanghofgreateraustin.org


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