(downloadable version)

BHARATIYA TEMPLE

BALBHARATI YOUTH COMMITTEE

MEMBERSHIP FORM

NAME: - _____________________________________

ADDRESS: - ________________________________

___________________________________

AGE / DOB ______________________

PH NO: - _____________________________(H)____________________________(C)

E-MAIL: - ______________________________

SCHOOL ATTENDING: - ____________________________________

GRADE: - _______ YEAR OF GRADUATION: - _________

OTHER EXTRA CURRICULAR ACTIVITIES DURING THE YEAR

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

PARENT'S NAME: - __________________________________

__________________________________

CURRENT TEMPLE MEMBER: - YES___ NO____

WHAT ARE YOUR REASONS FOR JOINING THE TEMPLE YOUTH COMMITTEE?

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

(You have to be 13-19 years of age to be a member of the Balbharati Youth Committee)