Membership Application Form                                                           Not-For-Profit, Cultural, Educational and Humanitarian Organization                                                           Project "ONOBLEMAN": Dedication of Gandhi statue on UNF campus Personal Information First Name:                Last Name:             Spouse First Name:   Spouse Last Name: Address Line 1:          Address Line 2:       City, State:                Zip:                        Phone:                      E-mail:                   Membership Contribution Student (SM):      $10.00              Annual(AM):     $25.00              Life(LM):     $100.00 Donor (DM):        $250.00              $500.00              $1000.00              Above $1000.00 Sponsor (SpM):      Bronze-$3000.00          Silver-$5000.00          Gold-$10000.00         Platinum- Above $10000.00 Instructions 1. Fill this application 2. Print the application 3. Make cheque(s) payable to 'Gandhi Memorial Society, Inc.' 4. Send the cheque and the printed application on the mailing address at the top of membership application form. ---------For GMS,Inc. office use only--------- Received an amount of $ (in words) Vide cheque #                 Dated From