________________
Name (Please Print):
Address:
Phone: Home:
Email:
2. Name:
Last
Address:
MIS REGISTRATION FORM
Work:
First
Birth date:
Smoke: YES/NO
Height:
Vegetarian: YES/NO
Drink: YES/NO
Current Marital Status: Never married/ divorced. If divorced, number of yrs. married:
If divorced, reason for divorce (optional):
Current U.S./Canada visa status:
Education:
Major:
Under graduate school attended:
Graduate School attended:
Work Experience:
Father's Name:
Name of the Jain Center you/your parents belong to:
Please provide two references, whom we may contact for your reference:
Phone:
1. Name: Address:
Jain Education International
Middle
Cell:
Number of years in U.S./ Canada:
Minor:
Mother's Name:
Phone:
(May attach a separate sheet. if desired)
Weight:
Candidate's Signature:
Date:
Important Notes: 1.You may include an optional recent photograph. 2. Your MIS form and advertise will be kept in our files for a maximum of one year. after which it will be destroyed. 3. You MUST include your ad, typed on a separate piece of paper, as you would like it to appear in Jain Digest. in no more than 40 words. Any MIS forms missing this may not be published in Jain Digest. OR at our option we may format your ad for publication in Jain Digest.4. You MUST include your contact information in your ad 5. Jain Digest reserves the right to edit your ad. refusal to publish and/or verify the information provided by you. 6. You MUST include a check in the amount of US $30.00 per issue of Jain Digest payable to JAINA along with your MIS registration form. 7. Jain Digest is a quarterly publication, normally published in January. April, July and October. Your registration material MUST be received by the 10 day of the previous month to be included in the next issue of Jain Digest.
Please mail completed MIS registration form along with a check to:
Mukesh M. Doshi, 1540 Sandburg Drive, Schaumburg, IL 60173-2183.
You may register for MIS online by logging in to, www.jaina.org/mis/jdmis_main.asp
For further information you may call (H) 847-517-2505 OR (Cell) 224-558-4345 OR Email: mukusha @ gmail.com
Disclaimer: MIS is a service of JAINA, a not for profit tax exempt organization. MIS and JAINA assume no responsibility for the accuracy or the authenticity of the information published in ads or any consequences resulting thereof. By voluntarily placing your ad in Jain Digest. you agree to hold JAINA, MIS Director, JAINA officers, its agents and its employees harmless for any consequences resulting through and by MIS service...
For Private & Personal Use Only
20/ JAIN DIGEST Fall 2008
www.jainelibrary.org
