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Membership Application

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Check One:  Life Member     Family Member     Single Member
First Name:
Last Name:
Address:
Town / City:
State:
Country:
Postal Code:
Phone:
Fax:
Occupation:
E-Mail Address:
Suggestions
(if any):

Please complete the above information and submit it, then remit appropriate amount to the address shown below or bring with you during programs.

Single and Family Membership are yearly beginning January and ending December

SINGLE -
$25.00

 Single persons - unmarried brother, sister or other relatives living together or with a family member

FAMILY -
$51.00

 Husband, wife, children under 18 years of age

LIFE -
$301.00

 Any person over 18 years of age, married or single
(Membership paid once during the whole life)

Make check / money order payable to Gujarati Samaj of N.Y., Inc.
Gujarati Samaj is a non-profit tax exempted organization - Tax ID# 23-7346761

    


HISTORY | UPCOMING PROGRAMS | PROJECTS UNDERTAKEN

MISSION STATEMENT | BOARD OF DIRECTORS | MORE INFORMATION

Gujarati Samaj of New York
173-15 Horace Harding Expressway
Flushing, NY 11365
Phone/Fax: 718-357-8GS1
gsnyweb@hotmail.com

Copyright 1998 Gujarati Samaj of New York. All rights reserved.