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 Name Middle Name Last Name
Spouse Name

First Name Middle Name Last Name
E-mail *
Phone Number: *

Area Code Phone Number
Alternate Phone Number:

Area Code Phone Number
Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Birth Date:

Month Day Year
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

Dance Singing Instrumental Drama Writing Public Speaking Drawing
Child(ren) would like to

Learn
Activity

Dance Singing Instrumental Drama Writing Public Speaking Drawing
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 colleauge Facebook Advertisement News Article
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