School Membership Application

School Information

Person Completing This Form

School Contact(s)

List up to 5 contacts involved with campus activities (clubs, marketing, events, pub, speakers, orientation, etc.)
* N.B. The primary contact name listed will be your primary COCA contact and must receive COCA email.
Please ensure that non primary contacts agree to receive email sent thru the COCA Directory before checking items 2 and 3 below their names.

Additional contact names (6, 7, etc.) can be added at a cost of $25 each. (List additional names on separate sheet.)

Primary Contact

N.B. Primary contact automatically listed in Membership Directory and must agree to receive COCA mass email.

2. Additional Contact

3. Additional Contact

4. Additional Contact

5. Additional Contact

Campus Information

Campus Enrolment (Approximate)

Campus Venue 1

Campus Venue 2.

Campus Venue 3.

Campus Venue 4.

Campus Venue 5.

Campus Newspaper Information

Campus Radio Station Information

Number of Campus Events Per School Year

Person(s) Authorized to Make Contract Offers on behalf of your Association or Dept.:

Person(s) Authorized to Sign Contracts on behalf of your Association or Dept.:

Membership Fees: Payment must accompany application form.