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Person Details:
Please Note that * Denotes Required Field!
First Name* : Last Name* :
Home Phone* : Cell Phone :  
Email* :      
Street* : City* :  
State : Zip Code :  
Gothram : Nakshathram :  

Family Details:
First Name Last Name Relationship Gothram Nakshathram

Sponsorship Details:
If you are unable to attend in person, our priest will include your names during sankalpam for your sponsorship. Feel free to contact us at info@qchindutemple.com. Temple will mail Akshata and Kumkum to your address.

(Please select the Kalasa / Event you would like to sponsor)
Kalasa / Event Amount
Golden Kalasa
Every day Homam, abhishekam and Kalyanam (include all events)
Silver Kalasa
Every day Homam, any one abhishekam and Kalyanam
Copper Kalasa
One day Homam, any one abhishekam and Kalyanam
Homam - Lakshmi
Friday morning
Homam - Sudarsana
Saturday morning
Homam - Hayagreeva and Saraswathi
Sunday morning
Abhishekam - Sri Lakshmi
Friday morning
Abhishekam - Shiva
Friday evening
Abhishekam - Sri Venkateswra Swami
Saturday morning
Kalyanotsavam $101
Total $
Silver / Copper Kalasa sponsors, please contact priest or front desk with your Homa / Abhishekam preferences

Check Number : Check Date :  

(Please DO NOT send Cash. Pay only at the Temple)

(Please send the Check)

(Please make your check payable to Quad City Hindu Temple)

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Quad City Hindu Temple
Address: 9801 14th St W, Rock Island, IL 61201 (Near Ridgewood Elementary School)
Phone: 309-787-HIND (4463)
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