1531 Russell Street # 26, Berkeley, California 94703, USA
CA 3155308 501 (C) (3) 170 (b) (1) (A) (vi)
Phone 1-510-323-6802 email: admin@nepalassociation.net nagcglobal@gmail.com
www.nepalassociation.net
MEMBERSHIP APPLICATION FORM
Full Name
Membership type
Due Amount
Mailing Address
State/Province/dist.
Country
Education
Employment
Email Address
Name of spouse
Spouse contact
Other family members.
1
2
3
4
5
6
Name
Relation
Age
I certify that above information about me is true and current to the best of my knowledge. I support the cause of Nepal Association for Global Cooperation and make a voluntary commitment to participate in the activities of NAGC as far as practicable.
(* By checking the above box, you are signing electronically and agree the above statement)
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Please Note that this membership is valid after appropriate payment and registration in the head office or the chapter offices. Misuse of this form is subject to consequesnes as per the laws of the land where this organization is operated.
Phone No
Recommended by: .
Contact
Chapter
Details of the Membership Dues
Life Membership US $200.00 All Chaptesr
Patron Membership US $100.00 All Chapters
America Chapter Family Membership US$10.00
America Chapter Single Membership US$5.00
Australia Chapter Family Membership Aus $10.00
Australia Chapter Single Membership Aus $5.00
Europe Chapter Family Membership Euro 10.00
Europe Chapter Single Membership Euro 5.00
Middle East and Africa Chapter Family Membership US $ 2.00
Middle East and Africa Chapter Single Member US $ 1.00
Greater Asia Chapter-Family Member US $ 2.00
Greater Asia Chapter-Single Membership US $ 2.00
South Asia Chapter Family Membership IC 20.00 or equivalent
South Asia ChapterSingle Membership IC 10.00 or equivalent
Nepal Chapter Family Membership NC 20.00
Nepal Chapter Single Membership NC 20.00
