Membership Package Renewal – Canada Please enable JavaScript in your browser to complete this form.Name *FirstLastPhone *Previously used Kutumba phone no used in previous year *Only USA and Canada Phone Number are allowedEmail *Previously used Kutumba Email used in previous year Location *City, Province, Example : Richmond Hills, Toronto , CanadaMembership status *Expiring in month/ExpiredNot SureIf not sure, please send email [email protected]If you are registering first time to system, please register link hereMembership No/Phone NoPrevious membership no or previously linked phone noPayment Mode *Cheque(Send to Shivalli Kutumba ,2005 Valley run Blvd , London, Ontario, N6G 5M8)E Transfer E Transfer Email ID : [email protected] | check favoring to “Shivalli Kutumba of North America”Membership Type and Fees(CAD)10 Years Term – Grand Patron – $1,000.0010 Years Term – Patron – $500.0010 Years Term – Family – $225.00*10 Years Term – Single – $90.00*Annual – Student – $5.00*Annual – Single – $10.00Annual – Family – $25.00* Single/Student – If you are married, please do not choose this optionBank Name *Ex: RBCPostal Service and posted date *Ex : UPS and 12th May 2021E Transfer Transaction ID *E Transfer Date *Ex : 12th May 2022Misc NotesSubmit
