Brahmin Samaj of Georgia, Inc.
(A registered 501 (c)(3) Tax Exempt Organization)  EIN # 582180725
P.O. Box 80162
Atlanta, GA  30366
Tel/Fax: 770-662-8628
E-mail:  BSOGATLANTA@HOTMAIL.COM
Website:  https://members.tripod.com/~Brahmin_Samaj_of_GA/


5TH ANNUAL ALL BRAHMIN CONVENTION - 2003
GENERAL REGISTRATION FORM


Mail completed for before May 31, 2003 to:  BSOGA, 1380 Cornerstone Place, Tucker, GA  30084, USA
Name:
          


Date of Birth:
Occupation:
Name:


Date of Birth:
Occupation:
Name:


Date of Birth:
Occupation:
Name :


Date of Birth:
Occupation:
Address:


City:

  
State:
Zip:
Country:
Phone: (H)


Phone: (W)
Fax:  
Cell:
Gotra:
    

Native Place:
E-Mail:          
PLEASE PRINT:  ALL INFORMATION IS REQUIRED TO PROCESS REGISTRATION.  Please make check Payble to in U.S. Funds to:  BSOGA, Inc.

To accommodate maximum delegates we are doing all that is possible to cut the cost and still strive for best quality services.  Your donation to BSOGA, Inc. is Tax Deductible.


REGISTRATION FEE(S):
(1)    $80.00 PER PERSON RECEIVED POST MARKED BY MAY 31, 2003.
         Grandparents over 65 are admitted for free, but still need to register.  (Grandparents are our pride and joy, and blessings.  We will honor them if you register NOW).
(2)    $100.00 PER PERSON FOR REGISTRATION AND PAYMENT RECEIVED AFTER MAY 31, 2003.

        Registration includes one Convention Directory/Souvenir, participation in Convention Activities, Breakfast, Lunch and Dinner.
      Lodging is to be paid by registrant directly.

I, the undersigned, and the other family members listed by me above, have received, read, understood and hereby agree, acknowledge and accept all the rules-regulations and guidelines set forth for the convention participation.  We further agree to release, indemnify and hold BRAHMIN SAMAJ OF GEORGIA, INC., its members and the organizers harmless from any and all actions and liability, of any nature whatsoever, consequential or otherwise, resulting from or relating to this convention.

Signature:
Date:

Date Received:
Check #  or Cash:
Total Amount:
Total Attending:
Notes: