Membership

Member Registration

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FirstName	LastName	Age	Relationship

Membership

Family Yearly Membership ( $ 25 )

Individual Yearly Membership ( $ 15 )

Would you like to volunteer in the future MCIA events: Yes No

Comments: (List out any talents you or your family have which will help the community)

PayPal Payment Method :

Instant Checkout through PayPal Cash/Cheque

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Paypal process will be replaced with quick pay/cash pay app soon, meanwhile you can make checks in the name of MCIA and handover to below mentioned volunteers:

Ajay Rolla : 309.826.0969

Samba Gurijala : 309.838.5254

Sailaja Lanka : 312.215.0767

Urmy Das : 309.433.4321

Karthik Goteti : 571.438.7810

Shweta Kathlesar : 309.750.1998

Membership is open to all.

Membership feee : $25

ADDRESS: McLean County India Association, PO Box 375 Bloomington IL 61702-0375

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CONTACT US

Ajay K Rolla, President
McLean County India Association PO Box 375 Bloomington IL 61702-0375

Email : OurMCIA@gmail.com
Phone : 309.826.0969

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