Sai Datta Peetham

Receipt Date:

Gotram:

First & Last Name:

Nakshatram:

Spouse Name:

Nakshatram:

Children 1:

Nakshatram:

Children 2:

Nakshatram:

Children 3:

Nakshatram:

Middle Name:

Last Name:

Mailing address:

Mobile Number:

Home Ph Number:

Email id:

Join the SDP SSVT Monthly Supporters – Life Membership

I would like to become a Life Member of the SDP SSVT Monthly Supporters and be part of the SDP SSVT Family. I have completed this form and I’m submitting a contribution of $51 / $101 / $151/ $201. I agree that my information will be kept on record as long as I remain a member.

In Addition to the above…..

"SDP SSVT Monthly Supporters contributing $51 per month are entitled to receive a daily Archana offered to a deity of their choice."

DEITY for Archana:

"SDP SSVT Monthly Supporters contributing $101 per month are entitled to a daily Archana offered to a deity of their choice, along with Monthly participation in 2 Abhishekam’s whenever they areperformed."

DEITY for Archana:

Abhishekam1:

Abhishekam2:

"SDP SSVT Monthly Supporters contributing $151 per month will receive a daily Archana to a deity of their choice, along with participation in up to 4 Abhishekam's each month, whenever they are performed."

DEITY for Archana:

Abhishekam1:

Abhishekam2:

Abhishekam3:

Abhishekam4:

"SDP SSVT Monthly Supporters contributing $201 per month will receive a daily Archana to a deity of their choice, along with participation in up to 6 Abhishekam's each month, whenever they are performed."

DEITY for Archana:

Abhishekam1:

Abhishekam2:

Abhishekam3:

Abhishekam4:

Abhishekam5:

Abhishekam6:

"SDP SSVT Monthly Supporters are also entitled to request an special Archana to any deity on their special occasions, such as birthdays, wedding anniversaries, or other personal milestones."

"We warmly invite all community members to join the divine SDP SSVT Monthly Supporters Family and help make our temple a truly unique and cherished icon in the community."

This Membership Proceeds will be used towards SDP SSVT Expansion and other daily rituals & Annaprasada Seva.

I authorize SDP SSVT to charge the selected amount and payment period to my card. I understand my details will be stored securely and this authorization will remain active until I choose to cancel.

Note: For Enquiries/Information please reach out to Raghu Sarma Sankaramanchi @ 516-359-8178.

Monthly ( 1-Abhishekam )

Monthly ( 2-Abhishekam )

Monthly ( 4-Abhishekam )

Monthly ( 6-Abhishekam )

Other

Total Amount:

To become a Monthly Supporter, please:

Fill out the Credit Card Authorization Form below

Received with thanks:

*Type of Credit Card

*Name on the credit card

*Credit Card Number

*Card Exp Month/Year

*[CVV2 #]

*Card Verification

Remarks:

Accepting to display name in SDP Groups?

SDP SSVT MONTHLY SUPPORTERS

In Addition to the above…..