Gujarati Samaj of Sacramento

Membership Form for New Members

Membership Plan

ANNUAL - $100.00 (Valid thru January 1st thru December 31st)

LIFE - $1000.00 One time Donation

Fill out the form for membership application, please do not use all Cap letters.

Membership Type *

First Name *

Last Name *

Middle Initial

Email ID *
Email ID is used as Login ID for next time login into the application

Password *
Parent's or Relatives who are currently living in your home.

Confirm Password *

Spouse's First Name

Children's First Names
Children currently living in your home. (Example:Bobby, Beena, etc...

Parent's Name *
Parent's or Relatives who are currently living in your home.

Membership covers permanent residents of:

Street Address 1 *

Street Address 2

City *

Zip *

Email address *

Alternate Email address

Telephone Number *
Ex: 916-234-5678 (Please use this format)

Alternate Telephone Number
Ex: 916-234-5678 (Please use this format)

Are you interested in Volunteering?

Can we put you on a Volunteer Team (for Diwali Programs, Picnics, etc.)?

Yes

List your areas of interest or activities
Cultural Team, Planning, Cooking, support, etc.

Are you interested in receiving occasional information about private events or promotions?
Proceeds will help raise money for the Samaj programs.

Yes

Your fees help support GSS programming. Thank You!
Annual Membership - $100.00
Life Membership - $1,000.00

To Complete Your Membership Application...

1. Make check payable to: "Gujarati Samaj of Sacramento"

2. Bring Check to a GSS Event, ( or ) Mail Check to:

GSS Treasurer
Mr. Urvish Panchal
4279 Sardonyx Way
Rancho Cordova, CA 95742