2007
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
-
Continuing
Education and Industry Training
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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