*** CPOC Online Membership Application


Conservative Patriots of Orange County
On-Line Membership Application

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The amount of the dues for all classes of membership shall be set by the Board of Directors and approved by the membership.
The fiscal year shall be the calendar year from January 1 through December 31.
Dues for new members accepted into membership after Oct. 1 shall be credited to the following year.



Membership Type:

I would like the newsletter:

NAME (as you want it to appear in the roster):
     Last Name:
     First Name:
     Middle Initial: (optional)
     Birth Date ( Month/Day):
     *E-MAIL:

NAME (second name for couples only):
     Last Name:
     First Name:
     Middle Initial: (optional)
     Birth Date (Month/Day):
     *E-MAIL:

ADDRESS:
     STREET ADDRESS:
     CITY:
     ZIP:


HOME PHONE:


CELL PHONE:

*It is important that we have your e-mail address. There are times when critical information must be sent to our members ASAP. Your e-mail address will be used only for Club purposes.

I learned about CPOC from:



I am a registered voter who is registered as a:

I uphold the values and principles of our country's founding documents and I believe that our Constitution should be revered and upheld. I believe that individual liberty should be cherished and maximized. I also believe in limited government, local control, sound money management and free enterprise.


THANK YOU FOR YOUR INTEREST IN CONSERVATIVE PATRIOTS OF ORANGE COUNTY

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