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* Mandatory fields

Contact Data

*First name(s)
Enter member's first name. If two individuals are associated with the record add both first names, i.e. Jim & Mary. If second person has a different last name, enter name in household member1. Also include prefix if appropriate, i.e. Rev, Dr, etc.
*Last name
Enter last name of member. Add suffix as appropriate, i.e. Sr, Jr, PhD, II, MD, Esq. If there is a second person with different last name, enter name in name of household member1.
Enter primary email address.
*Phone primary
Enter primary phone number in (xxx) xxx-xxxx format.
Phone secondary
Enter phone number other than primary in (xxx) xxx-xxxx format.
*Phone unlisted
Indicate if phone number() are an unlisted number or not.
*Mailing address1
Enter address where mail is received.
Mailing address2
Enter street address if post office is mailing address, or apartment number, unit number, etc.
Enter name of city.
*Zip code+4
Enter 5 digit zip code plus 4 digit suffix; i.e. 12345-6789.
Country of residence.
*Donation date
Date donation made.
*Amount ($USD)
Enter only the numeric value of the total dollar amount of donation. Do not include the "$" sign; i.e. 25, 50, 100.
*Donation fund
For multiple donations; enter the total amount of donation and in the comment box specify the specific fund and amount you which to donate too. Example: Total mount $40, Cultural Center $20 & Homeland $20.
Used by donator to make a comment regarding his/her donation.

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 The Carpatho-Rusyn Society is a non-profit, 501(c)(3) organization dedicated to manifesting Carpatho-Rusyn culture in the United States and supporting Rusyn culture in the Homeland in east central Europe.  It works to educate Rusyns and non-Rusyns about Rusyn culture and history, and to support the development of Rusyn culture on both sides of the Atlantic.   As a membership organization, it boasts over 1,800 members worldwide who support the organization's work through their annual contributions of dues as well as voluntary contributions to funds that support Rusyn cultural development abroad as well as humanitarian aid for Rusyn communities in Europe.


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