Membership Form Phone Main Applicant details First Name * Last Name * Email * (will be used as primary contact method) Phone no: * Address Line 1 * City * Post Code * Membership type * Adult Student Individual Life Time Senior Citizen Date of Birth * Additional Applicants details Additional Applicants 1 First Name Lastname Date of Birth Membership type Adult Student Individual Life Time Senior Citizen Email Additional Applicants 2 First Name Lastname Date of Birth Membership type Adult Student Individual Life Time Senior Citizen Email Additional Applicants 3 First Name Lastname Date of Birth Membership type Adult Student Individual Life Time Senior Citizen Email Additional Applicants 4 First Name Lastname Date of Birth Membership type Adult Student Individual Life Time Senior Citizen Email Message (optional) How did you hear about NANIS Recommendation from a friend Internet Search Family or Friends Are Already Members This form will help Norfolk And Norwich Indian Society (NANIS, Est 1983) to hold relevant information about you and arrange events and functions that cater to the tastes and ages of ALL its members their families. Your help in completing this form will help your committee help you and is much appreciated By verifying Captcha, I consent to you storing and using their personal information to get back in touch with me. *