Chinmaya Mission Seattle
Membership Registration 2023-2024
Are you new to Chinmaya Mission Seattle?
*
Yes
No
Membership type (one registration for the entire family)
*
Family membership (2 or more children) ......$225
Single child family membership ......$175
Individual/Family Membership (no children in Bala Vihar or Shishu Vihar) ......$150
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Family Information
Your Name
*
First Name
Last Name
Your Email
*
example@example.com
Your Phone
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Spouse Name
First Name
Last Name
Spouse Email
example@example.com
Spouse Phone
Please enter a valid phone number.
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Bala Vihar Information
Child 1
*
First Name
Last Name
Child 1 Grade
*
Please Select
Pre-School (3 or younger)
Pre-K
KG
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
(in 2023-24 academic year)
Child 2
*
First Name
Last Name
Child 2 Grade
*
Please Select
Pre-School (3 or younger)
Pre-K
KG
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
(in 2023-24 academic year)
Would you like to register another child
*
Please Select
No
Yes
Child 3 name
*
First Name
Last Name
Child 3 Grade
*
Please Select
Pre-School (3 or younger)
Pre-K
KG
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
(in 2023-24 academic year)
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Additional Information
Pictures and videos of group activities will be used in publicity material.Do you give your consent to Chinmaya Mission Seattle to photograph, videotape, or otherwise digitally record and use images and/or sound recordings of yourself and/or your child or children (if applicable) to use in any public media, including social media and print. The intended use of such images and information is solely for the purpose of promotional and public awareness purposes for the organization.
*
Please Select
Yes
No
Chinmaya Mission Seattle is a 100% volunteer (sevak) run organization. By becoming a member of our community you have a unique opportunity to practice seva. Seva is the spirit of selfless action without any expectation of rewards or personal benefit. Will your family be able to volunteer this year?
*
Please Select
1 Balavihar day (= 2 hours)
3 Balavihar days (=6 hours)
5 Balavihar days ( = 10 hours)
10 Balavihar days (= 20 hours)
15 Balavihar days (= 30 hours)
20 Balavihar days (= 40 hours)
25 Balavihar days (= 50 hours)
Does your employer and/or your spouse’s employer offer Corporate Matching for donations made to 501 (c) (3) eligible nonprofit organizations?
*
Please Select
No
Yes
Company Name
*
Second Company
*
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Payment
Membership Cost
Child 1 Textbook
Child 2 Textbook
Child 3 Textbook
Sub total
Convenience Fee
We are charging a convenience fee to cover credit card transaction fees.
Total
Total
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USD
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