Anavil Samaj of Canada


	ABOUT ANAVIL SAMAJ

	ARTICLES & BI-LAWS

	OUR MEMBERSHIP

	DIRECTORY UPDATES

	USEFUL ARTICLES

	LINKS & RESOURCES

	OUR SPONSORS

Last Name:

First Name:

Middle Initial:

Spouse's Name:

Email:

* only if you want to be listed in the directory

Address:

Postal Code:

City:

Prov:

Home Phone:

Business Phone:

Father's Name:		His Hometown:
Mother's Name:		Her Hometown:
Spouse's Parents
Father's Name:		His Hometown:
Mother's Name:		Her Hometown:

Family Members, living with you in Canada
Full Name	Relation	Date of Birth (mm/dd/yy)	Marital Status

Please Note:

• Information provided on this form will be available to every family in the Anavil Samaj of Canada.
• Please complete this form and press send information button below.
• If you prefer to mail or fax to the Publication Office click here to download or print a copy of this form.
• If you are single, please complete box 1 under family members.

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