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• Please provide the following contact information:

  First name
  Last name
  Street address
  Address (cont.)
  City
  State/Province
  Zip/Postal code
  Home Phone
  FAX
  E-mail
  Webpage if u have one:

• Hobbies:

  BasketBall  BaseBall    FootBall    Computers 
  Skiing      Camping     Rafting     Volleyball
  Reading     Cricket     Nothing =)  

        Other Hobbies or interest:

       

• You come to Mandir:

  Regularly
  Once a month
  On Major Events
  Whenever I Feel
  
  Do you do Pooja or Mala:

  Never
  Sometimes
  Daily

• Do you Have Any Friends in the Mandir:

  
  

• Please identify and describe yourself:

  Date of birth
  Sex	Male Female

• Any Other Comments You Would Like to Make:

  
  

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Webmasters -Darshan & Brijesh