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Membership Form
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Membership Form
Membership Application
English
नेपाली
Membership Information
First Name
*
(required)
Last Name
*
(required)
Email
*
(required)
Phone Number
*
(required)
Street Address
Optional
Zip Code
*
(required)
Are you a Nepali national with Temporary Protected Status (TPS) in the United States?
*
(required)
Yes
No
Where did you hear about us?
*
(required)
Family, friends, or your contacts
Facebook/Instagram/Social Media
News media
Other
How would you like to be involved in supporting TPS holders and families?
*
(required)
Select at least 1.
Participate in advocacy (calls, petitions, contacting elected officials)
Meet with elected officials (in person or virtually) to share your TPS story
Help with digital advocacy (social media, content creation, storytelling)
Support mutual aid (donations, resources) or fundraising efforts
Attend community meetings or information sessions
I would like to stay informed but cannot participate right now
Other
By submitting this form, you consent to being contacted via the phone number and/or email address you have provided. This contact may be for purposes related to campaigns and advocacy. We are firmly committed to the principles of confidentiality, and we will not share any of your information with third parties.
*
I understand and consent to be contacted by phone and/or email for the purpose stated above.
*
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