CONTACT US:
MEMBER NAME PHONE EMAIL
President Mrs. Rashmi Jakhotia (813) 962-4172 ramjakhotia@gmail.com
President Elect Mrs. Bela Sharma (813) 000-0000 ramjakhotia@gmail.com
Treasurer Mrs. Uma Rattahalli (813) 000-0000 Info@fia-tampabay.com
       
  FIA of Tampa Bay Personal Registration Form
 

NOTE: Information provided below is strictly and exclusively for FIA use only and will not be released to any individual or the organization.

   
 
LAST NAME
FIRST NAME
NAME OF THE SPOUSE
STREET ADDRESSS
CITY
STATE
ZIP
HOME PH#
CELL PH#
E-MAIL ADDRESS
   
  MEMBER OF THE FOLLOWING LOCAL INDIAN ORGANIZATIONS:
 
1. _______________________________
2. _______________________________
3. _______________________________
4. _______________________________
  CLICK HERE TO PRINT YOUR REGISTRATION FORM HERE.
 

NOTE: PLEASE COMPLETE, PRINT AND MAIL THE FORM TO BELOW ADDRESS:

 

ADDRESS: FIA of Tampa Bay ∙ PO Box 342216, Tampa FL 33694