Please register me for participation in the services of LDSF and send me information:

Name: ______ _________________________________________

Address: ____ _________________________________________

Address: ____ _________________________________________

City: ________ _________________________________________

State:_______ _________________________________________

Pin /Zip code: _________________________________________

Country:_____ _________________________________________

Phone Number: _______________________________________

E-Mail Address: ________________________________________

[ __ ] 1. I am interested in working through LDSF in the areas of :

----------- [ _ ] i. Hindu Temple Reconstruction & Renovation;

----------- [ _ ] ii. Priests & Poojaris Welfare Programs;

----------- [ _ ] iii. Hindu Dharma Education Programs;

----------- [ _ ] iv. Health care and Social Service Programs;

[ __ ] 2. I would like to join in the LDSF related activities in and

------------- around my native town ____________________________ .

------------- or in the Ishta Devatha Temple _____________________

------------- Located in the city of _____________________________ .

[ __ ] 3. I am pledging a Donation payment of : _________________________

------------- as my contribution towards the Activities and services of LDSF.

{Please e-mail your pledge - we will notify you instructions for mailing the contribution}

Signature: ________________________________________