INDIAN AMERICAN CULTURAL CENTER OF NWIHRC

8605 Merrillville Road • Merrillville, Indiana 46410 • (219) 756-1111

MEMBERSHIP FORM

Categories of Membership

Trustee Membership - Donations of $13,500 or more or $375 per month checkomatic

Donations of a cumulative sum of $13,500.00 or more or over a period of 5 years with $3,500 payable initially and $2,500 payable every year (by June 1) in subsequent 4 years.

Patron Membership - Donations of $6,000 or more or $170 per month checkomatic

Donations of a cumulative sum of $ 6000.00 or more or over a period of 5 years with $ 2000 payable initially and $1000 payable every year (by June 1) in subsequent 4 years.

Life Membership - Donations of $1,250 or more or $35 per month checkomatic

Donations of a cumulative sum of $ 1250 or more or over a period of 4 years with $ 365 payable every year.

Annual Membership - Donations of $100 per year – Annual Membership

The annual membership is for the calendar year.

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Upgrade the membership:

INDIAN AMERICAN CULTURAL CENTER OF NWIHRC

8605 Merrillville Road • Merrillville, Indiana 46410 • (219) 756-1111

I am a:

I would like to upgrade my membership to:

INDIAN AMERICAN CULTURAL CENTER OF NWIHRC

8605 Merrillville Road • Merrillville, Indiana 46410 • (219) 756-1111

Trustee

Patron

Life Member

Annual Member

Donor

Trustee

Patron

Life Member

INDIAN AMERICAN CULTURAL CENTER OF NWIHRC

8605 Merrillville Road • Merrillville, Indiana 46410 • (219) 756-1111

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Membership Benefits

  1. A member above 18 yrs will have voting rights 60 days after the membership is granted.
  2. Can contest for any position in the organization with appropriate membership category.
  3. Members are charged less at every IACC event.
  4. Special rates for members for Hall rental.

Name______Date ______

Home Address______city______state_____Zip______

Cell Phone ______Home Phone ______Office Phone______

Spouse’s Name______Cellphone______

E-mail Address ______

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I would like to donate the above amount in:

1 installment (1 Year) 2 installments (2 years) 3 Installments (3 years) other

Please attach this form with your generous check payable to: NWI Hindu Religious Center

Non Profit Tax ID #35-1981658and mail it to the above address.

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Are you interested in setting up a monthly donation?

Yes, please make sure to fill out checkomatic form below

NO

MEMBERSHIP CHECKOMATIC AGREEMENT

I (we) herby authorize NWI Hindu Religious Center to initiate debit entries from my (our) checking account/savings account indicated below and the BANK named below, hereinafter called Depository, to debit same to such account.

Depository Name: ______

Bank Name ______City ______St ____ Zip______

Routing Number ______Account Number ______

Account Type: Checking Savings Loan

This authority is to remain in full force and effect until NWIHRC and depository has received written authorization from the undersigned to terminate these transactions.

Name ______Amount $ ______

Signature ______Date: ______