INDIA CLUB OF GREATER DAYTON
MEMBERSHIP APPLICATION

To Renew Membership: You do not need to fill this form again if you are a returning member.

Just mail your check to the address below. If any of your contact information has changed,

please contact us at membership@indiaclubdayton.org

New Members: Please fill in all the information in this form.

Full Name:
E-mail	Please make sure to provide your email. We will confirm your membership via email.
Spouse’s Name
First Names of Children and their ages
Telephone
Address
City
Zip
Select Membership Type	Family ($25) Individual ($15) Lifetime ($250) Student ($5)
Comments
Please send me newsletters and regular communications regarding India Club activities.

Payment Instructions:
Please make check payable to: India Club of Greater Dayton

Mail Check and Form to:
Sudha Mani
India Club of Greater Dayton
2800 Chesney Ct.
Centerville, OH 45458
For Additional Information, please call Sudha Mani - 937-885-9028

India Club of Greater Dayton Appreciates Your Support.