2006
Central Coast Claims Association
Membership Application
This form must be printed and then filled out and mailed to
the address below, along with your check...Or, bring it with you to the next
meeting.
Name:______________________________________________
Mailing Address:_____________________________________
City:_______________________ State:______
Zip:________________
Business Phone#: ___________________________________
Business Fax#:_____________________________________
Email:____________________________________________
Company Affiliation: ________________________________
Current Position:____________________________________
Membership
Benefits Include:
·
A free
monthly copy of Central Coast Claims Association News Network newsletter
·
Priority
registration for the Golf Tournament
·
Discounted
luncheon costs (Member
cost = $25, Nonmember cost = $35)
·
Continuing
Education and Industry Training
Individual
Associate Membership Annual Dues: $50.00
Individual
Adjuster Membership Dues: $25.00
Corporate Membership (Unlimited) Annual Dues: $100.00
Additional Names for Corporate Memberships
Name:
_______________________________________ |
Name:
_______________________________________ |
Name:
_______________________________________ |
Name:
_______________________________________ |
Please
make checks payable to C.C.C.A. Application and check should be mailed to:
Central Coast Claims Association
c/o Shelly Lefore
Casualty Adjusters Guide of Northern California
15920 La Escuela Ct.
Morgan Hill, CA 95037 408-782-5998
Federal ID# 91-2031381