MADHURI DESHMUKH – Indian Cultural Society

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Venue Location

Jacksonville, FL 32225

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Date/Time

Fri, 10/13/2023 – 08:00 PM

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MADHURI DESHMUKH

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hello@jaxics.org

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(904)-770-5127

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Cultural Performance Entry Form

Youth Committee Volunteer Registration

Youth Committee Candidate's First & Last Name *

Parent's Full First & Last Name *

YC email ID *

YC Phone number *

Parent Phone *

Parent Email Address *

Current Grade Level *

Birth Month *Please enter your month & year of Birth to check eligibility for ICS member only PVSA Awards

Birth Year *

Please do not fill in this field.

Poster Competition Form

Primary Contact/Parent Name *

Participant Name *

Contact Email *

Contact Number *

Age Group *

Participation Type

Entry Description

2024 India Day Poster Competition

Consent

Do you give permission to share on ICS Social Media

Participation fee : $10
Convenience Fee For Online Transaction. ( 3.00% ) : $0.30
Additional Fixed Convenience Fee. ( 30 Cents ) : $0.30
Total Participation fee : $10.60

Participation fee

USD

Credit / Debit Card *