Member Registration

FirstName LastName Age Relationship


Family Yearly Membership ( $ 25 )
Individual Yearly Membership ( $ 15 )
Would you like to volunteer in the future MCIA events: Yes No
(List out any talents you or your family have which will help the community)

PayPal Payment Method :

Instant Checkout through PayPal Cash/Cheque

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 Gurijala309.838.5254

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