India Community Center of Rochester 2171 County Line Road, Macedon, NY 14502 We strongly encourage you to actively participate and support our ICC

ICC Membership Form Recommended: ICC now has the facility for online membership renewal with PayPal. Please consider renewing your membership online, by visiting: https://sites.google.com/a/iccrochester.org/membership/pay-membership-online OR Mail membership dues together with this form to: Vithal Sanapala, 633 Bonnie Brae Ave, Rochester, NY 14618 Make check payable to: India Community Center of Rochester Basic Annual Membership*

($100 minimum)

Full Time College Student*

($20 minimum)

Seniors* (Age 65 and above)

($50 minimum)

Life Members

($3,000 minimum – can be paid in three annual installments)

Your Email Address(es): __________________________________________________________ (Your email address is very important for us to send out information that you will want to know in most economical and environmental friendly way. Thank you)

Dr./Mr./Mrs./Ms. ____________________________________________________________________ Name of Spouse: __________________________________ Preferred Telephone: _______________________ Address: _____________________________________________________________________________ (Optional) Children names and ages: ___________________________________________________ Interested in volunteering for events at ICC?

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Questions? Please email to: [email protected] *Note: Your annual membership expires the following year on the last day of the previous calendar month.

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