New Membership/Renewal Form:

    NAME:                 

                           (First)                                                        (Last)

    Address:       

    Home Phone:     Work Phone:  

    Name of Spouse: 

    Name & Ages of children : 

    Type of Membership Preferred:        Regular ($25/yr.)

                                                                 Life ($500/yr.)

    (Please make checks payable to `TAMPA TAMIL ASSOCIATION OF USA`)

    Comments (Please list any activities you desire for the association and any special talents

                         you may  wish to contribute)

    Signature                                                                                     Date

   e-mail address:   

    Please mail to:

                                                       TAMPA TAMIL ASSOCIATION

                                                        Mr. Sundaram Shanmugam

                                                         9704 Cypress Brook Road

                                                         Tampa, FL 33647