Shri Dwarkamai Vidyapeeth

Individual Registration

Please enter information in the form below to process registration for event Food Drive Sunday March 29.

First Name *

Last Name *

Address

City

Phone *

Email *

Comment:

Full meal ($14):

Full meal

Sabudana Wada ($8):

Wada

Massalabaat ($6):

Massalabaat

Vada Paav ($8):

Vada Paav

Halwa ($3):

Mango Halwa

Masala Chai: ($2)

Masala Chai

Payment Information

Amount

$

Payment Method *

Paypal / Credit Card / Debit Card : : (All through Paypal Interface) Offline Payment

Billing Zipcode*

Credit Card Number*

Expiration Date*

/

Card (CVV) Code*

Card Holder Name*