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
Recommended by.
Name of spouse
Spouse contact
Other family members.
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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 consequesnes as per the law of the land where this organization is operated.
