BSCFL - Membership Information Form

MEMBERSHIP INFORMATION FORM

Applicant Name:*
Email:*
Birth Year:	Age: 0 Yrs
Gender:
Home Phone:	() - -
Cell Phone:	() - -
Address:*
City:*
State:
Zip Code:*	5 digit zipcode
Upload photo:	You can upload your recent photo, passport size (2" x 2"), in one of these file formats: JPG, PNG, GIF. Maximum file size allowed is 50kb. If you do not have any photo editor on your computer, you can use free websites like http://pixlr.com/

	For security reasons, enter the text you see in the above graphic:


	INDEPENDENCE DAY- PICNIC Saturday, August 15, 2020 MARY HOLLAND PARK BARTOW
	NAVRATRI 2020 WEEK 1 FRIDAY Friday, October 9, 2020 BARTOW CIVIC CENTER BARTOW
	NAVRATRI 2020 WEEK 1 SATURDAY Saturday, October 10, 2020 BARTOW CIVIC CENTER BARTOW

Terms, Conditions and Privacy Policy

Copyright 2013 Bhartiya Samaj of Central Florida