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अंतरा्चष्ट्ीय डहनदी सडमडत
International Hindi Association
A NON-PROFIT ORGANIZATION G 2129 Stratford Road, Murfreesboro, TN 37129 G TAXID 58-1988753 G Founded by Late Dr. Kunwar Chandraprakash Singh in 1980
MEMBERSHIP FORM सदसयता आवेदन-्त्र (PLEASE PRINT IN CAPITAL LETTERS)
उपिाम Last Name ...............................................................................................................................................................
प्रथम िाम First Name ..................................................................................................................................................................
जीवि साथी का उपिाम Spouse’s Last Name: ...................................................................................................................................
प्रथम िाम First Name........................................................................................................................................................................
पिा Address:...................................................................................................................................................................................
शहर City: .............................................................. प्रांि State: .................................................कोड Postal Code: .................................
राष्ट्र Country: ..............................................................................................................................................................................
दूरभाष Home Phone : .................................... Work Phone: ............................................ Mobile Phone: .....................................
ई-मेल E-mail: ...................................................................................................................................................................................... Introduced by: Name...................................................Phone...................................Email.................................................... ..........
कृ्या कोई एक डवकल् रुनें Please check one of the following :
Please make check or bank draft payable to ‘International Hindi Association’ in USD and mail to:
Ranbir Kumar, 141-34 79th Ave, Apt 1B, Flushing, NY 11367, USA. Phone: (347) 665-7719; Email: treasurer@hindi.org
Bank Name: .......................................................... Check / Draft No................................... Date ...............................
The membership provides the following benefits:
1. A subscription of widely acclaimed quarterly literary magazine Vishwa published from the U.S. in Jan, April, July and Oct.
2. Discounts on IHA products and services such as Hindi CDs, kavi sammelan, seminars, conferences, and youth-clubs.
3. Rewarding volunteer opportunities in many valuable programs in the USA and India.
4. Access to Member’s-only information, and prior notification of events.
5. Regular Membership provides right to vote on matters of the Association after a waiting period of sixty days.
The Board of Directors maintain the right to deny, suspend or cancel membership of any individuals who fail to abide by the Articles of Incorporation or the Bylaws or whose activities are deemed detrimental to the proper functioning of the Association. The Board is not obligated to refund any unused portion of the membership dues for cancelled membership.
‘Vishwa’ welcomes original writings in Hindi from all quarters. Writings dealing with immigrant experiences are especially welcome. For further information, or to submit your writings for consideration, please contact: The Editor, Mr. Ramesh Joshi, 10046 Parkland Drive,Twinsburg, OH 44087, USA. Phone USA +1 (330) 688-4927, India +91 94601 55700; Email: joshikavirai@gmail.com & editor@ hindi.org
Visit www.hindi.org to contact us or for additional information.
For Official Use only:
PASSPORT SIZE PHOTOGRAPH
डनयडमत आजीवन Regular Life Member: डनयडमत वाड््चक Regular Annual Member: वया्ार/संस्ा वाड््चक Annual Institutional:
Ì $250 USD Ì $35 USD Ì $500 USD
Assigned Member Id: ........................................... Signature ........................................ REV JAN 2019
