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REQUEST FOR MEMBERSHIP APPLICATION
INDIA ASSOCIATION OF NEW ORLEANS
P.O. Box 641104, Kenner, LA 70064-1104
Membership for 2010
(Membership
"Active"
from January 1 to December 31, upon payment of yearly dues)
First Name :
*
Last Name :
*
Address:
*
Street:
Apt. No.:
City :
*
LA. Zip Code :
*
Home Telephone Number:
E Mail Address:
*
Yearly Membership Fee: $40 for Family with Kids, $30 for Couples, $20 for Singles and $10 for College Students
* indicates required fields
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