2012 Central Coast Claims Association
Membership Application

Individual Associate Membership Annual Dues: $50.00 Individual Adjuster Membership Dues: $25.00
Corporate Membership (Unlimited Individuals) Annual Dues: $100.00

Adjuster Membership $35 for calendar year 2012 please fill out info before submitting *Adjuster Name, & Company *Contact Phone & Email	Associate Membership $75 for calendar year 2012 please fill out info before submitting *Associate Mbr Name, & Company *Contact Phone & Email	Corporate Membership (unlimited) $150 for calendar year 2012 please fill out info before submitting *Contact Name, & Company *Member Names Phone & Email

Please click here to pay for your annual membership by check.

Federal ID# 91-2031381

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