ISKCON” INTERNATIONAL SOCIETY FOR KRISHNA CONSCIOUSNESS Founder-Acharya : His Divine Grace A. C. Bhaktivedanta Swami Prabhupada Branch: Off. East Coast Road (ECR) Bhaktivedantha Swami Road, Hare Krishna Land, Akkarai , Sholinghanallur, Chennai, Tamil Nadu, INDIA. PIN: 600119 Phone: 9840366108 E-mail: iskchelifepatron@ gmail.com Web: www.iskconchennai.org Life Patron Membership Programme Registered office: Hare Krishna Land, Juhu, Mumbai - 400 049 Tel.: (022) 2628 6579 « E-mail: [email protected] Registered under Maharashtra Public Trust Act, 1950 ‘Trust Registration No. F-2179 « PAN: AAATIOO17P Hare Krishna Hare Krishna Krishna Krishna Hare Hare Hare Rama Hare Rama Rama Rama Hare HareINTERNATIONAL SOCIETY FOR KRISHNA CONSCIOUSNESS Founder-Acharya : His Divine Grace A. C. Bhaktivedanta Swami Prabhupada APPLICATION FOR LIFE PATRON MEMBERSHIP | wish to enroll as a Life Patron Member of the International Society for Krishna Consciousness and am making a ‘donation of Rs 35,555/- towards the Corpus of the Trust. | understand that this membership is not transferrable. Sri Smt. Kum. pete [0] > ][m[m][y Ty] ¥[v ‘Surname / First Name / Middle Name EE Ns LT PIN oFrice appress — PIN Phone No./ Mobile No. MEE courany occuranion nrorMATON lease provide information regarding your company or occupation: pHa Products / Services provided by you / your company (Business ( Service [LJ Professional Type of Susiness [-] Retired Manufacturing CO trade MEE anonstrucrion zz Feheed ame ater a a ale A) [Cy Residence [] Office (Oy Engin =] Hing «= Other LanguageMEE PeRsONAL AN FAMILY NFORMATION — TT Please give details of yourself and your family living with you to help us serve your spiritual needs: No. Name of Family Member (Including yourself) Relation Date of Birth e|sfolalalelr Please provide important date/anniversary. All members will have a special puja performed on this date. Please provide information regarding your education and training to help us suggest appropriate opportunities for your devotional service: ‘Academic Qualification Please provide {two passport size Field of Study / Experience recent photographs Please provide information on other organizations you are associated with: Lt INTRODUCTION a you know of any person(s) who may be interested in becoming Life Patron Member(s) of ISKCON, please provide details below: No. Name Address Phone Number 1 2 3 4 MEE) essorrensonanencst Please check the areas of spiritual training and development programmes that you are interested in: [1] Guided study of Vedic Literature Oy Wership at Home [J Satsang groups in your areaEEE Por TUNES FoRcONTREUTON TT As allfe patron member of ISKCON your continuing support is essential. ISKCON has many programmes for you to contribute substantially o the charitable work of the society. Please indicate the areas you would be interested There is an opportunity to make a monthly donation to the temple by instructing your bank to make an online remittance to ISKCON's bank account. C. Please tickhhere to get more information on this service. Lord Krishna personally protected cows. Lord Krishna is very pleased with one who renders service to cows. Please {get unlimited blessings from lord Krishna by participating in cow protection. C. Please tick here to get more information on this service. Please indicate below the areas or items of Sri Murti seva you would be interested in. You may offer donation(s) on anniversaries of family members. Also you may make an endowment or perpetual service: CO Bhog Seva OO Vaastu Seva CO Archana Seva ‘VAASTU DAAN Members can contribute goods and materials to the Society for its work. Foodstuffs, cloth and other materials are accepted as donations in kind. Please indicate below any item of your own company or otherwise which you would be interested in donating. Product(s) : ee FREE VOLUNTEER SERVICE _ There are many opportunites for the members of ISKCON to perform free volunteer service. Please check the area(s) youmay be interested in anda devotee will discuss further details with you: O Medical Services CO Drama Production Graphic Arts CO Educational Services Oat D Printing & Publishing (Computer Systems Oo Music Editorial Services CO Architecture C1 Photography © Regional Languages Translation CO Engineering 1 Video Film Ol Public Relations Gi Construction Management 1 Interior Design In addition to the above professional areas there are many opportunities for giving volunteer service in the temple. Please check the areas you maybe interested in: Temple Service CO Free Food Distribution O Festivals Introduced by ISKCON Representative ‘Signature of Applicant If the payee is other than the applicant, kindly provide Moca tReet cnn Deum the following [5] cheque [J cash || cheque No. Name fie Adee SS~™C DN FTRTGSHOMNe | Dae D CreaivDebit Card Bank Of rnc PIN PAN. Bank account details ‘OR CODE Temporary Receipt No. Bank account name: ISKCON Bank account no.: 821010034038490 Bank: AXIS Bank Permanent Receipt No. Branch: Tiruvanmiyur, Chennai IFS Code: UTIB0000423, Membership No. ‘After making online payment, kindly send transaction details to 19551857610 / [email protected] Ecee RDS,