Gujarati Samaj of Detroit - 2025 Membership Form
Membership effective from January 1, 2025 to December 31, 2025
PayPal Link: https://www.paypal.com/ncp/payment/9SMQH9CW7W65W
Or use this Form
MEMBERRSHIP RENEWAL
LIFE MEMBERSHIP – UPDATE INFO
Renew my membership based on last year’s profile. | Please complete Sections 1 & 3 below. | I am a Life Member; please change/update my information. | Please complete Sections 2 & 3 below. | ||||||
Member Email Address: _____________________________________________ | |||||||||
SECTION 1: MEMBERSHIP CATEGORIES & FEES | |||||||||
Family Membership | Husband, wife, unmarried children under 25 years of age, and parents living in the same household. Due Date for Renewal is May 31, 2024. | Please note: | Membership renewal fee will be $50 after May 31, 2025. | $50 One year | $150 Three year | ||||
Single Membership | Single as defined by IRS (Only one person is allowed) | $25 | |||||||
Senior Membership | One spouse is 62 years of age or above (Only two person are allowed) | $25 | |||||||
Life Membership | Lifetime affiliation with Samaj | $751 | |||||||
Corporate Membership | Corporate Membership | $101 |
SECTION 2: MEMBERSHIP INFORMATION
Member’s Full Name: | Age: yrs | ||
Spouse’s Name: | Age: yrs | ||
Child Name: | M / F | Grade: | Age: yrs |
Child Name: | M / F | Grade: | Age: yrs |
Child Name: | M / F | Grade: | Age: yrs |
Child Name: | M / F | Grade: | Age: yrs |
Father’s Name: | Age: yrs | ||
Mother’s Name: | Age: yrs | ||
Street Address: | |||
City: | State: MI | Zip: | |
Telephone (required): | Email 1: | Email 2: | |
Gujarati Samaj, Inc. will maintain address and e-mail information with strict confidence and will not use / give it to others for solicitation. |
SECTION 3: ACKNOWLEDGEMENT & AUTHORIZATION
I, undersigned understand that this membership application will be reviewed by Secretary of Gujarati Samaj, Inc. I also understand that the membership fees are non-refundable. The above information is true and correct to the best of my knowledge. I understand that any misrepresentation or falsification will result in the cancellation of my membership and I will be responsible for non-member fees if the membership was used during any of Samaj’s events, such as Holi, Navratri, Diwali and other events. By providing the contact information above, I understand that GSOD may communicate with me via phone, e-mail or USPS. |
SIGNATURE: ______________________________________
DATE: ___________
Please Make Check Payable to: Gujarati Samaj, Inc. | |
Form & Check Mailing Address: G.S.O.D., C/o Satish Shah 43284 Westphalia Ct, Sterling Heights MI 48314 | |
Questions? Please send an e-mail to | Secretary@GSOD.org |
FOR GSOD OFFICIAL USE ONLY:
Payment for 2025 Gujarati Samaj, Inc. Membership received: Secretary: | ||||||||||||
Date Form Received: | Check Amount: $ | Check Date: | Check #: | |||||||||
Membership
form also available on www.GSOD.org
Scholarship forms
https://www.gsod.org/scholarship-form
GSOD Membership
Lifetime Membership: Lifetime affiliation with Samaj
Family Membership: Husband, wife, unmarried children under 25 years of age, and parents living in the same household
Single Membership: Single as defined by IRS
Senior Membership: One spouse is 62 years of age or above
Upcoming Events
GSOD Sponsorship
Gold: 4 Tickets – Holi, Navratri, and Diwali Program (Each event)
Diamond: Provide 1 Table during the event (if required)
Silver: For events E-Blast, we will put Silver sponsors name at bottom of the email
Diamond: Include Full Color Page Ad for Samaj Darshan
Platinum: 10 Tickets – Holi, Navratri, and Diwali (VIP Seats) Program (Each event)
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Date : 2023-08-19