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Step 1 of 1Rejoin and New Membership Request
 
Please use this form to:
 Member Rejoin
 New Membership Request (Former Boating or PCOC Graduates)
Membership Type (if you know)
 Regular
 Associate
 Do not know
If it is a family Membership request, also check the following box.
 Request Family Membership
Indicates a mandatory field.
If known, enter the Membership or Person's Record Number.
Member Information
CPS Membership or Record No.: 
Last Name: 
First Name: 
Initial: 
Street Address 1: 
Address line 2 (Optional): 
City: 
Province (State): 
Postal Code: 
Country: 
Home Phone: 
Business Phone: 
Cellular Phone: 
Fax: 
e-mail Address: 
Squadron (If you know): 
Transfer From:
Old Squadron: 

Family Membership

If a Family Membership is desired, entre the Family Head Membership Information
Family Head Last Name: 
Family Head First Name: 
Family Head Member Number: 
Family Head Squadron: 
Enter your comments here (DO NOT provide Credit Card Information):

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