(A registered Non-Profit Cultural and Secular Organization)
1642 COLONIAL HILLS DR. ,MCLEAN VA 22102
E-mail: Web: www.washingtontamilsangam.org
Membership Application – 2016
Name of the member: ______
(Last name) (First name)
Name of the Spouse: ______
(Last name) (First name)
Mailing Address: ______
______
Telephone No: ______
(Home) / (Cell) (Work -optional)
E-mail Address: ______
Membership: (Please, check appropriate boxes)
Family Life Membership - $500
Family -- $ 35/annual Single -- $ 25/annual
Payment: Cash Check No:______Credit Card
Name(s) of the family member: (for family membership only)
1) ______Adult/child 2) ______Adult/child
3) ______Adult/child 4) ______Adult/child
Interest of members: (If you are interested to participate or contribute in any of the following areas, please specify)
Tamil class Youth activities Thenral Mullai Magazine
Cultural programs l Literary meetings Any other :______
Signature: Date:
Please fill this form, make your check payable to Tamil Sangam of Greater Washington, Inc., and mail along with your check to:
Dr.VIJAYAKUMARMUTHUSAMY, 1642 COLONIAL HILLS DR. ,MCLEAN VA 22102.
or
To update your membership information and pay your dues online, please visit
www.WashingtonTamilSangam.org/members