Membership form | Sindhuli Society of America

First Name *

Last Name *

Gender Male *

Gender Female *

Phone number *

Email address *

Address *

City *

Zip Code *

State *

Country *

Date- MM/DD/YYYY *

Membership - Annual *

$15

Membership- LifeTime *

$150

Payment Method - Zelle *

For Zelle please use this Email ID- sindhulisamajusa.info@gmail.com

Payment Method - Cash *

Please Use below message box to mention person's Name, Address and Phone number whoever collects the cash from you.

Message *