Long Island Nepalese Society, New York

Admin login (optional)— only required for admin tasks such as selecting Honorary membership

Signing in is optional. New members do not need to sign in to submit the form.

🎟️ Membership Type

Choose the membership that fits you

Membership Fee

USD 15.00

Payment instructions

To make a Zelle payment:

Send Zelle to longislandnepalese@gmail.com.

After payment, please contact the President to verify and complete your registration:

Kul Prasad Gouli (Rajan) — +1 (718) 974-7252

Other payment methods

For payments other than Zelle (cash, check, bank transfer, etc.),

Contact the Co‑Treasurer:

Ram Kumar Rai — +1 (516) 800-5478

Important: Registration will remain incomplete until full payment is received and verified.

💡 No online payment. Invoice & payment instructions will also be emailed.

⚠️ Applicants and Junior Members between the ages of 16 and 18 are not entitled to voting rights.

First Name *

Middle Name

Last Name *

Date of Birth *

Street Address *

Apartment, suite, etc.

City *

State *

ZIP *

Phone *

Confirm Phone *

Email *

Confirm Email *

Preferred Contact Method *

Mandatory Documentation (select one) *

Declaration for Eligibility and Participation in the Electoral Process

I certify that I will appear in person at the designated polling site with a valid DMV-issued ID. I agree to follow all election rules and the code of conduct. I understand that providing incorrect or unverifiable documents will disqualify my voting eligibility.

म New York DMV द्वारा जारी परिचयपत्र सहित तोकिएको मतदान स्थलमा भौतिक रूपमा उपस्थित हुने प्रतिबद्धता व्यक्त गर्दछु। म निर्वाचनका सबै नियम र आचारसंहिताको पूर्ण पालना गर्नेछु। मैले पेश गरेको कागजात गलत, अवैध वा अप्रमाणित भएमा मतदान अधिकार स्वतः खारेज हुने कुरा म पूर्ण रूपमा बुझ्छु।

I acknowledge and accept the declaration. (Required)

I acknowledge that invoice and payment instructions will be emailed. (Required)

Signature (derived): (Full name will be used as signature)

Please fix the following before submitting:

Please enter Day, Month and Year for Date of Birth.
Select Preferred Contact Method.
You must accept the declaration.
You must acknowledge the payment note.
ZIP must be 5 digits.
Enter a valid email address.
Enter valid phone number no dashes or space. Exactly 10 digits required.