Individual Registration

Please enter information in the form below to process registration for event Vijaya Dashami- 14 Year Temple Anniversary-2024.

First Name *

Last Name *

Address

Address 2

City

Phone *

Email *

Gothram

Nakshtram for family members

Kalasha Abhishekam: *

Sponsorship ($51)

Amount

Payment Method

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

Billing Zipcode*

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Holder Name*