________________
Fresh Ideas
Please complete the following membership form if you are within the ages of 14-29 and are interested in joining - Young Jains of America. Send the completed forms to: Anil Jain, Director of Membership - YJA, 758 Brookside Circle, Elmira, NY 14903.
Young Jains of America
परस्परोपग्रह जीवानाम्
General Information: Last Name: Permanent Address:
City:
Member I.D. (Zone Number; YJA use only):
Today's Date:
State:
Current Electronic Mail Address (if applicable): Home Telephone Number: ( )
Date of Birth (MM/DD/YY):,
Federation of JAINA Membership Form 1993-1994
/
Married? Yes No If Yes, Spouse's Name:
Parents' Names:
&
Date of Birth (MM/DD/YY) of Spouse:
High School Information:
High School Name:
College Information:
University/College:
Most Recent (or current) Degree/Major: Previous Degrees/Majors and/or Schools Attended:
Young Professional Information:
Profession (list primary field(s)):_
Employer/Company:
Position/Job Title:
Business Address:
First Name:
Current College Address:
Current College Telephone Number (if applicable): (
Bus. Telephone Number: ( )
I do not want:
28
Jain Education International 2010_02
Home Fax Number: (
Jain Ctr. Affiliation:
1
Zip Code:
).
JAIN DIGEST
Check if currently a high school student Class of:
Bus. Fax Number: (
Check if currently a college student Class of
Valid Until:
For Private & Personal Use Only
)
M.I.
)
Any of this information published in an upcoming YJA directory. My home ☐ college business phone number(s) published.
June 1994
www.jainelibrary.org
