Membership Request Form - BAPS Public Affairs

Region *

Center *

Enter your nearest BAPS center

Name *

First Name

Last Name *

Last Name

Occupation *

Employer *

Cell Phone *

Email *

Payment Information

Membership *

Membership: $100.00

Credit Card *

Billing Address *

Billing Address

City

State/Province

Zip/Postal

VoluntarilyCommit *

I voluntarily commit to contributing the above amount to the BAPS Public Affairs Inc membership for the calendar year 2022. I confirm that I am a U.S. citizen or have been lawfully admitted to the U.S. with permanent resident status and that my contribution is made with my own personal funds and has not and will not be provided or reimbursed by any other person or entity. I understand that contributions or membership fee payments to BAPS Public Affairs, Inc. are not deductible as charitable contributions for federal income tax purposes.