Membership Form Membership Number: ICS0040First Name *Email Address * Date of birth *Street Address *City *State/Region *Postal Code *OccupationHome PhoneMobile *Would you like Indian Community Southland Inc publications sent to your email address? *YesNoPlease select your interests from the many events/activities we host to receive email or phone call, Information, updates & alerts. *Cultural ActivitiesSocial ActivitiesEducational ActivitiesSports ActivitiesNone of the aboveWould you like to volunteer your time or services in any way towards ICSI? *YesNoWhat could you bring as a member of ICS Inc. *How did you hear about ICS Inc? Select MembershipGeneral MembershipCore Committee Membership Fees to payCredit / Debit Card *Fore your protection, this form is secured with 256-bit SSL encryption. Annual membership (GST Inclusive) for an individual 18 years of age and over. Subscription membership year is one year from the date of joining.Apply Membership
