Dollar a Day Sponsorship form
Devalaya Samrakshana Nidhi. Your support towards Temple Maintanance.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Account type
*
Personal Checking
Personal Savings
Business Checking
Business savings
Account type
*
Single
Joint
Amount to be donated every month
*
$251.00
$101.00
$51.00
$31.00
Bank Name
*
Bank Routing Number
*
Bank Account Number
*
Account Holder Full Name
*
Month to Start the donation
*
e.g. July 2023
Gothram
*
Enter Name, Nakshtra and Rashi for Sankalpam
*
Rows
Name
Nakshatra
Rashi
Birth month & Date
1
2
3
4
5
6
Signature
*
Please verify that you are human
*
Submit
Should be Empty: