Membership Package Registration – USA Please enable JavaScript in your browser to complete this form. – Step 1 of 2Reference Check *Kutumba Existing Member ReferenceNo existing reference, send email to committee with details and registerAlready sent email/talked with committee memberAs per the Kutumba security new guidelines , reference check is mandatory process. *Accuracy of the below data is key thing for Kutumba registration. Kutumba existing member name *FirstLastKutumba existing member email **After registration, reference confirmation email will be sent to this email. Kutumba existing member phone*After registration, Membership committee may reach out here for any reference check *Reference should be only from USA and Canada numbersEmail to Kutumba Committee *Content of this will sent to Kutumba Committee , please send the information of 1.How did you know about Kutumba ? 2. Introduction about your home town and your work/study info if you are student? 3. Why you want to join Kutumba?Information about connect with Kutumba Committee over email/phone *Information of Kutumba communication 1. Provide the date when the email was sent to [email protected] (if applicable only)? 2. Provide the committee person info you connected over phone ?NextName *FirstLastPhone **Phone no should be only from USA and Canada numbersEmail *Please use the email which was used in previous yearCity *CityFamily Name *Example : Saralaya, Mattu,Ancestral Home town/Native place *Example : DharmasthalaSpouse Name (If you are single, please say NA) *Spouse Phone Number(If applicable)(Optional – its required if they want to be part of Whats App group) *Phone no should be only from USA and Canada numbersSpouse Email (Needed for Election)Select State *AlabamaAlaskaArizonaArkansasNorth CaliforniaSouth CaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingMembership Id/Phone No (If you have taken before)Previous membership no/Phone no if applicable only *In case of Phone no, Please use only USA and Canada numbersWhat is the communication preferred to contact you? *EmailWhatsAppBothIf not sure, please send email [email protected]What you are looking from Shivalli Kutumba North America Association?Preserve Cultural & Religious ValuesPlatform to connect and NetworkMatrimonial forumVolunteering and Charity workKids Educational forumLearn Tulu/Kannada LanguageOthersDo you have Honorary Membership code? *YesNoNot SureMembership coupon code(Honorary Membership) *This should be max 20 digit Unique code for every one provided by Kutumba Committee , If you have any questions, please reach out to [email protected] Membership will not be provided for invalid coupon codes. Validity of coupon code is 1 year from the time of registration Payment ModePaypal(via Credit/Debit Card ,Bank Account)Check(Send to Shivalli Kutumba, 1911 Hartshorn Ave, Troy, Michigan , 48083)Zelle TransferCoupon code(Honorary Membership) Zelle Email ID : [email protected] | check favoring “Shivalli Kutumba of North America” If you have entered the valid coupon code provide by committee , please select coupon code as payment modeMembership Type and Fees10 Years Term – Grand Patron – $1,000.0010 Years Term – Patron – $500.0010 Years Term – Family – $225.00*Annual – Single – $10.00Annual – Family – $25.00*2 years Family(New) – $50.00 * Single membership is strictly only for unmarried people. If you have single membership and your marital status changes, you should change your membership to ‘Family’ as soon as possible the same year. * 2 years Family membership is valid till April 2027Membership Type and Fees*10 Years Term – Grand Patron – $1,020.8010 Years Term – Patron – $510.6510 Years Term – Family – $230.10*Annual – Single – $10.70Annual – Family – $26.02*2 years Family(New) – $53.00* PayPal fees extra * Single membership is strictly only for unmarried people. If you have single membership and your marital status changes, you should change your membership to ‘Family’ as soon as possible the same year. * 2 years Family membership is valid till April 2027Bank Name *Ex: ChasePostal service provider and posted dateEx : USPS/12th May 2022Zelle Transaction ID *Zelle Date of Transfer *Ex : 12th May 2022Misc NotesKutumba ByLaws I confirm that I have read and shall agree to the Shivalli Kutumba Bylaws and code of conduct (Please refer https://shivallikutumbana.org/constitution/)Kutumba constitution linkSubmit
