CCOA Member Area - New Member

Cougar Club Of America

Membership Area

IMPORTANT NOTE: This form is for NEW members only. If you are currently a member or were a past member, please click here to RENEW your membership.

Download the Membership Form

First Name

Last Name

Additional Member First Name (optional)

Additional Member Last Name (optional)

Address Line 1

Address Line 2

City

State/Province/Territory

Postal Code

Country

Home Phone

Work or Mobile Phone

E-Mail

This is a Gift Membership From

Keep Address Private
Check this box to keep your address private. This will prevent you from being listed in the CCOA Roster.

Keep Phone Numbers Private
Check this box to keep your phone number private. It will not be listed in the CCOA Roster.

Opt Out of E-mail Newsletters
Check this box to opt out of all e-mails. This includes e-mails such as the newsletter, event notifications and special purchase options for items such as the Barber Tee Shirts, BBQ tickets, etc.

Who referred you?

Referring Member Number

Referring Member Name, Chapter, Division, or Sponsor

Both the CCOA and Cornerstone Registration, Ltd. respect your privacy. We will not share your information with any third-party for commercial gain. However, the CCOA may authorize the distribution of your name, address, and motrocycle information for club-related activities and literature (such as local meets and the annual Membership Directory). At your option, you may elect to keep your phone number and/or address private. Note, however, that if you do elect to keep your address private, you will NOT be included in the annual Membership Directory.