Vivah-Mela Registration Form
In New Jersey
September 20, 2003
Time : 11.00am - 7.00pm
Name :
Address :
Phone :
Fax :
E-mail :
Sex :
male
female
Height :
Weight :
Visa Status :
US Citizen
Green Card
H-1 Visa
other
Employment :
Education :
Caste :
Religion :
Mother Tongue :
Smoker :
Yes
No
Martial Status :
Single
Divorced/kids
Divorced/without kids
Widow/Kids
Widow/without kids
Hobbies :
Expectations :
To the best of my knowledge the above information is correct
Signature :
Dead line for Registration August 1, 2003:
Registraion Fee : $149.00
(10% Discount to Vivah Members)
Make Check payable to :
Vivah
Mailing Address
Vivah
115 West Lake Dreive
Carrollton, GA 30117
For More Info. Contact
Kshama Kakade
Phone
770-836-0469
Fax
770-836-0117
Email
mrsk1234@aol.com
website
www.vivah-mela.com