Membership Registration

Akhila Karnataka Kotari Welfare Association®

Membership Registration

Join our community — verify your mobile to begin

📱

Verify Mobile Number

A 6-digit OTP will be sent to your mobile number.
The registration form unlocks after verification.

🇮🇳 +91

Please enter a valid 10-digit mobile number.

Standard SMS charges may apply. OTP valid for 10 minutes.

OTP sent to . Enter the 6-digit code below.

Incorrect OTP. Please check and try again.

✔ Mobile number verified successfully!

Didn't receive it?

Personal Identity Membership Payment

👤

Personal Information

Basic details and contact information

Passport-size Photo *

Click to upload your passport photo

JPG or PNG · max 2MB · square preferred

Please upload your passport-size photo.

First Name *

Required

Last Name *

Required

Date of Birth *

Required

Gender *

Required

Email Address *

Enter a valid email address

Mobile Number *

✔ Verified

Pre-filled from OTP verification

WhatsApp Number

If left blank, mobile number will be used

Father's / Husband's Name *

Required

Sub Caste / Gothra (if applicable)

Native Place / Ancestral Village

Full Address *

Required

City *

Required

PIN Code *

Required

🪪

Identity Verification

Required for membership authentication

ID Proof Type *

Required

ID Number *

Required

ID — Front Side *

📄

Click to upload front of IDJPG, PNG or PDF · max 5MB

Please upload the front of your ID

ID — Back Side

📄

Click to upload back of IDOptional for Passport / PAN

Occupation

Organisation / Employer

Education Qualification

Field of Study (optional)

Brief About Yourself

★

Membership Type

Choose the category that best fits you

Single

₹500 / year

Individual membership open to all who support AKKWA's mission.

Patron

₹5,000 one-time

Lifetime recognition for distinguished supporters and benefactors of AKKWA.

Family

₹1,000 / year

Covers the primary member and all immediate family members under one registration. Add family member details below.

Please select a membership category.

How did you hear about AKKWA?

Referred by (Member name or ID)

💳

Payment & Declaration

Complete payment and submit your application

Registration Summary

Member Name—

Mobile—

Membership—

Amount Due—

Payment Method

📱 UPI

🏦 Bank Transfer

📄 Cheque / DD

Amount to Pay —

60s

Scan with GPay · PhonePe · Paytm · any UPI app
Amount ₹— is pre-filled automatically

or pay using UPI ID

akkwa@upibank

Copied!

Tap UPI ID to copy · open your UPI app and paste

UPI Transaction / UTR Number *

12-digit UTR from your payment confirmation

Please enter the UTR / transaction number

Account Name	Akhila Karnataka Kotari Welfare Association
Bank	Bank of Baroda
Account No.	06650200001029
IFSC Code	BARB0BRIGAD
Branch	Trinity Circle, Bangalore

Transfer Reference No. *

Please enter the transfer reference number

Draw cheque / DD in favour of Akhila Karnataka Kotari Welfare Association.
Send to: Maruthi Complex, 1st Floor, BEML Circle, Thippasandra, Bangalore-560075.
Write your name and mobile number on the back.

Cheque / DD Number *

Required

Bank Name

Cheque Date

I hereby declare that the information provided in this form is true, correct and complete to the best of my knowledge. I agree to abide by the rules, regulations and bylaws of Akhila Karnataka Kotari Welfare Association. I understand that providing false information may result in cancellation of my membership without refund.

I have read and agree to the above declaration and AKKWA's terms & conditions.

Please accept the declaration to proceed.

Security Verification *

Please complete the security verification.

✔

Application Submitted!

REF-000000

Thank you for registering with AKKWA. Your membership application has been received and will be reviewed within 5–7 working days. A confirmation email has been sent to your registered email address.