Canadian Tamil Youth Alliance

Application for Individual Membership

EDUCATION INFORMATION:
College / University	Name of institution	Under grad Post grad
		Full-time Part-time
	Faculty, Major

	Year	Expected date of graduation	Alternative Certificate

High School	Name of High School

	Grade	Expected date of graduation

	Are you planning to attend University/College or work after high school? Yes No
	If yes, where?
	What is your interested area of study/work?

EMPLOYMENT INFORMATION:	Full-time Part-time Contract
Name of Employer	Do you or your family own a business?	Yes No
Name of Employer	If yes, please provide name of business:
Period of Employment	Nature of business:
Period of Employment

WHAT ARE YOUR INTERESTS/HOBBIES/SKILLS?
Public Speaking		Developmental Projects
Politics		Photography
Event Coordination		Videography
Project Management		Web Design
Human Rights		Graphic Design
Please describe each of the areas that apply to you from the options listed below:
Athletics	Cricket Basketball Soccer Other:	Arts & Culture	Dance Music Visual Arts Other:
Writing	Articles Press-releases News Poems Reports Stories Other:	Social Media	Blogger Digg Facebook Flickr LinkedIn MSN MySpace Orkut Twitter Youtube Other:

Are you affiliated with any organizations, clubs, and or groups presently? Yes No

If yes, please list:

MEMBERSHIP INFORMATION:	New Membership Membership Renewal
Membership Options:	Consistent Member $25 Sustaining Member $100
Payment Method:	Master Card VISA

MEMBERSHIP CONSENT INFORMATION

I, declare having read and understood the Code of Ethics in its entirety and hereby consent to participate acknowledging all the foregoing.