GSTB MEMBERSHIP FORM 08

From: Subject: GSTB MEMBERSHIP FORM 08 Date: Fri, 7 Mar 2008 22:00:25 -0800 MIME-Version: 1.0 Content-Type: multipart/related; type="text/html"; boundary="----=_NextPart_000_0000_01C8809E.A5D2E8B0" X-MimeOLE: Produced By Microsoft MimeOLE V6.00.2900.3198 This is a multi-part message in MIME format. ------=_NextPart_000_0000_01C8809E.A5D2E8B0 Content-Type: text/html; charset="utf-8" Content-Transfer-Encoding: quoted-printable Content-Location: http://www.gujaratisamaj.org/membership08ONLINE.html =EF=BB=BF GSTB MEMBERSHIP FORM 08

Gujarati Samaj of Tampa Bay =20

MEMBERSHIP = FORM

Year 2008

Tel:=20 H:-- = W:-- = C:-- = FAX:--

City: State: = Zip:

Mailing = Address: =

E-mail=20 Address: @ .

Deadline for GSTB 2008 = Membership is April=20 30, 2008
No New Membership for 2008 will be accepted after = April 30,=20 2008.

Year 2008

<= /TABLE>

Amount: $ _________Date: = _________=20

Received by:_________

Cash/Check #:_________ =

<= /TABLE> Office Use Only: I.D. no: _________ Office Use Only: I.D. no: _________ If address, phone = # change,=20 Please Check Here 3. = = =20 = = ; =20 &n= bsp; &nb= sp; &nbs= p; =20 $75.00 4. = =20 = = ; &n= bsp; &nb= sp; &nbs= p; =20 $75.00 5. = =20 = = ; =20 &n= bsp; &nb= sp; &nbs= p; =20 $75.00 7. = =20 = = ; =20 &n= bsp; &nb= sp; &nbs= p; =20 $75.00 8. = =20 = = ; =20 &n= bsp; &nb= sp; &nbs= p; =20 50.00 A. = =20 = = ; =20 &n= bsp; &nb= sp; &nbs= p; =20 $50.00 9. = =20 = = ; =20 &n= bsp; &nb= sp; &nbs= p; =20 $50.00 B. = =20 = = ; =20 &n= bsp; &nb= sp; &nbs= p; =20 $50.00 This = membership is Non - transferable = &=20 Non -=20 refundable. &nbs= p; = ; = &= nbsp; &n= bsp; &nb= sp; =20 This = membership is Non - transferable = &=20 Non -=20 refundable. &nbs= p; = ; = &= nbsp; &n= bsp; &nb= sp; =20

Amount: $ _________Date: = _________=20

www.gujaratisamaj.org

= Received by:_________

Cash/Check #:_________ =

Please = print this page=20 and mail your application with check=20 to:

Gujarati Samaj of Tampa Bay
Piyush Patel, = Treasurer=20
3166 Spring Oak Ave.
Palm Harbor,FL 34684=20 &= nbsp; =20 Phone: 727-785-3836 Membership Year from January 1, 2008 = through=20 December 31, 2008 (Please use CAPITAL letters only to avoid errors in the = membership=20 directory.) CASH RECEIPT Please make sure that this box is=20 completedby &n= bsp; &nb= sp; =20 GSTB office when you pay CASH. Address:_____________________ Your Name:___________________

Annual=20 Fee

=20

=20 =20

(Married Children and=20 others living in the household)

6. = =20 = = ; =20 &n= bsp; &nb= sp; &nbs= p; =20 $75.00

2.Spouse=20 Name: Last = Name: =20 First Name: Middle Initial: =20 $75.00

There may be a nominal charge = for=20 some events for all members. This = membership is Non - transferable = &=20 Non -=20 refundable. &nbs= p; = ; = &= nbsp; &n= bsp; &nb= sp; =20 Please make check payable to: Gujarati Samaj of Tampa=20 Bay = &= nbsp; &n= bsp; &nb= sp; &nbs= p; = ; =20 Total::: &nbs= p; = ; = &= nbsp; =20

1.Primary=20 Member: Last Name: First Name: Middle = Initial: =20 = $75.00 &= nbsp; =20

----------------------------------------------------------------= -------------------------------------------

Name = ; = =20 Relationship = =20 Sex &nb= sp; =20 Age

(Unmarried=20 Children age 5 to 25, Senior Parents 60+, Non-Working & Living with = the=20 Primary Member only)

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