Pooja Seva Sponsorship 2023

Shirdi Sai Baba Sanstha
Pooja Seva 2023 Registration
Sponosor Pooja Service securely online or print form and contribute by mail or call. See instructions below

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Pooja Seva Information

Your choice of Pooja (Prayer):

Special Instructions:

Amount (USD):

Contact Information

First Name:

Last Name:

Address:

City:

Country:

State/Province:

ZIP/Postal Code:

Mobile Number:

E-mail:

Pooja Information

Gothra:

Nakshatra or Birth Star:

Raashi or Birth Sign:

Pooja to be performed on:

Family Information (required for family sponsorship)

Wedding Date:

Spouse Name:

Spouse Birth Star:

Spouse Birth Sign:

Other Family Member(s) Information:

Relationship Type	Name	Nakshatra or Birth Star	Raashi or Birth Sign

Credit Card Information

I have:

Card Number:

Name on Card:

Expiration Date:

Credit Card Code:

(Tip: Get another code than displayed above by clicking on the curved arrows image above a) if displayed code is hard to read or b) to avoid captcha errors if the form is not submitted in a stipulated time c) Finally, enter new code below before submitting the form to avoid processsing errors.)

Enter code(from image above, Refresh if needed): (Hint: Refresh image if hard to read)

I hereby authorize Shirdi Sai Baba Sanstha , to bill my Credit Card as shown above for the donation amount listed above and I promise to pay such amount subject to and in accordance with the agreement governing the use of such card.

To donate by Credit Card, fill the form and hit the submit button. When you submit, your information will be securely transmitted over the internet using SSL encryption. Alternatively you can call us at +1(847)931-4058 to donate or text us to (847) 565-9674 for questions.

To donate by Check make check payable to "Shirdi Sai Baba Sanstha", print and fill this form and please mail along with check to Shirdi Sai Baba Sanstha, 12N950 IL Route 47, Hampshire, IL 60140, USA