NIAASC

NATIONAL INDO-AMERIAN ASSOCIATION FOR SENIOR CITIZES INC.
Nonprofit as a 501 C3 entity Website: www.niaasc.org
ID 11-3473654
E-mail: niaasc@aol.com
NIAASC was created in 1998 with the help of Global Organization of People of Indian Origin (GOPIO)

DIRECTORY OF INDIAN AMERICAN SENIOR CITIZEN PROGRAMS AND/OR CENTERS IN THE USA

Name of Senior Citizen Program/Center (hereafter SP)

Name of program

Address where Program is located

Please Enter Full Address

Phone number

SP Phone number

Email

SP email address

Is it independent or component/affiliate of another entity? Please check one:
Independent
Component/Affiliate

If Independent - Is it an incorporated entity?
Yes
No
Please choose one

If Independent - Is the SP?
Not for Profit
For Profit
Please choose one

Year and Month the Senior Program was initiated

Enter the Year and Month the program started

Membership Status: How many members in your senior program?

Approx how many members

Does the SP have a Governing Body, Executive Council, or Board of Directors or any other?
Yes
No

If yes, Please provide the name of President (CEO):

Last name and First name

If yes, Please select one:

If it is a component of an organization, University or Institution (Parental Body),
Please provide name of Parental body:

Name of the parental body

President (CEO) name:

Last name and First name

Phone number

Contact phone number

Email

Contact's email address

Whether Independent SP or Component of an Organization: Please describe:

The principal officers for SP are selected or elected?
Selected
Elected

Describe activities, in brief, by the SP: Activity Name, Frequency, Normal attendance:

Contact Person providing information for this survey:

Last name and First name

Phone Number

Phone number

Email

Email address

If you know of any other Senior Program, please provide Name of Program:

Name of Program

Contact name of other SP

Last name and First name

Phone number of other SP

Phone number

Email of other SP

Email address

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