CCI Membership Form 

Membership  Form  -   Jan 01,2023 thru Dec 31st, 2023

Cultural Center of India

Attn : Sunil Patel

  300 E Franklin St, Richmond, VA 23219

Tel  #  804-536-2524  

Send your check to Above address Or once you submit this form you will see link to make payment online 

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                         CULTURAL CENTER OF INDIA 
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Single : $125
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Family (2 Adults) : $  250.00
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Family (2 Adults & 1 Kid) : $300
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 Family (2 Adults &2 and more Kids) $325
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Parent each person on top of membership (age under 75) $50 
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 Additional Adult above 18 : $50
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Last Name:
First Name:
Spouse’s Name:
Address: (with City , Sate and Zip code )
Tel No OR Cell No

Names of Unmarried Children DOB ( Optional ): Month/Year

Names of Retired Parents ( Living Under same Household& 75+ Age) - Free

Please Make Check Payable To: Cultural Center of India      Ref/Memo: 2023 Membership Dues

Mail To: Attn : Sunil Patel

Cultural Center of India

300 E Franklin Street, Richmond VA 23219

For Office Use Only:Check/Cash:$________#__________Date:__/__/______Recd By:__________

Note:  Membership Due is July 1, 2023 & All membership is NON transferable  

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