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Biannual Membership (Year 2019 & 2020)

New Member Full Name:
   
Address :
   
Member Cell Phone #:
   
Spouse Name With Father:
   
Spouse Cell Phone #:
   
Home Phone #:
   
Email:
   
Child/Sibling
DOB
   
   
   
   
   
Father Name:
   
Mother Name:
   
Date:
   
Credit Card Information and Authorization
   
Card Type *
   
Name on Card *
   
Credit Card Issuing Bank or Issuer Name *
   
Card Number *
   
Expiration Date *
 
     I agree to the terms and conditions and I authorized charge payment of to Digeswari Parivar USA. 
 
   

 

Make check payable to, Digeswari Parivar USA,INC

 

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