Membership request form

Persian Zoroastrian Organization Membership Form (2015)

Please fill out the form and return to Persian Zoroastrian Organization (PZO)

Family Membership*           ($60)                                         Individual Adult Member* ($30)

Student Membership/Senior Citizens ($20)   New Comers, Under 2 years in the USA ($20)

Last Name: ____________________________ First Name______________________________

Spouse Last Name: _____________________  First Name:______________________________

Home Address:__________________________Apt:________City:______________  State:____

 Postal Code: ___________ Tel (_____) _____-_____ E-mail:____________________________

Children: (under 18)*                 Name                                                               Year of Birth

•           ___________________________________            _____________________________

•           ___________________________________           ______________________________

•           ___________________________________              _____________________________

The applicants are required to give name of two Zoroastrian members as their Farsi-speaking Zoroastrian reference:

1-Last Name: _________________________ First: ___________Tel (_____) _____-_____

2-Last Name: ________________________ First : ___________ Tel (_____) _____-_____

Regular Member: Who is Zoroastrian and accepts its Bylaw.

Affiliate Member: Who is interested in this corporation and accepts its Bylaw.

Honorary Member: Who is recognized for his or her worthy services to Zoroastrianism and accepts its Bylaw.

Please consider my application for Persian Zoroastrian Organization’s membership.

Signature: _________________________________                       Date: _____/______/______

Please give your form to one of the PZO Board members or mail your form.

*Family Membership: Parents and their children under age of 18          *Individual Adult Member: 18 years and over

“All information provided is kept confidential.”    For official use only:

Approved by:__________________________________  Membership No: _________________

Acceptance Date: _____________________________ Membership Status: _________________

Note: ____________________________________________________________________________

DARBE-MEHR ROSTAM & MORVARID GUIV

10468 Crothers Road, San Jose, California 95127 Phone (408) 272-1678   Contact@pzo.info 

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