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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.

(Please select the Event you would like to sponsor)
Event Amount
Grand Sponsorship
All events Sponsorship
Three Days Sponsor
Three Days events Sponsorship
Two Days Sponsor
Two Days events Sponsorship
One Day Sponsor
One Day events Sponsorship
Homam Sponsorship
Abhishekam Sponsorship
Total $

Check Number : Check Date :  

(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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