HARTA Registration Form

HALTON REGION TAMIL ASSOCIATION MEMBERSHIP REGISTRATION

Complete the form below to sign up for our membership service.
When you are part of Halton Region Tamil Association, you will find the support you need to grow and improve your organization and further your individual professional development.

We are stronger together and that collectively we can affect positive change in the communities in which we work, both in Canada and abroad.

Membership Fee : Free

_________________________________________________________________________
Name*

First NameMiddle NameLast Name
Spouse Name

First NameMiddle NameLast Name
E-mail*
Phone Number:*

Area CodePhone Number
Alternate Phone Number:

Area CodePhone Number
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Birth Date:

MonthDayYear
Additional Family Members
(Name, Date of Birth)
Seniors Information if any*
(Name, Date of Birth, Interest's)
CHILDREN'S INFORMATION(if any)
Child(ren) would like to

Perform
Activity

DanceSingingInstrumentalDramaWritingPublic SpeakingDrawingOther
Child(ren) would like to

Learn
Activity

DanceSingingInstrumentalDramaWritingPublic SpeakingDrawingOther
Additional Details, if any
Name , Age and talent of your child or children based on the choice(s) above
How did you hear about us?

A Friend or colleaugeFacebookAdvertisementNews ArticleOther
Once your application is submitted, our administration team will contact you to get further information if any, and to complete your membership.

If you have any concerns feel free to reach us

haltontamil@gmail.com

Thank you!
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HALTON REGION TAMIL ASSOCIATION MEMBERSHIP REGISTRATION