To apply for or renew your membership please complete the form below and click the Review button. If you don't wish to complete the form online, please print, complete, and mail this form to COCRA.
New CSRs qualify for the Student rate. All contact and address information will be kept confidential.
Preferred Mailing Address: Home Work
First Name*
Last Name*
Home Address 1*
Home Address 2
Home City*
Home State*
Home ZIP*
Home Phone*
E-MAIL Address*
Union
Local
Work Address 1
Work Address 2
Work City
Work State
Work ZIP
Work Phone
FAX
Work County (Required)*
Select one of the following:
Help continue this important work!
Manage ER initiatives * Hire a lobbyist * Protect transcript income * Staff Reporting of the Record Task Force * Protect jobs * Improve employment conditions * And much more!
Show your support by becoming a COCRA Sponsor (in addition to your dues). You will receive special recognition in COCRA's newsletter and Official Briefs.
Pay by: Choose one... Check American Express Mastercard Visa
If paying by check: Make Check Payable to: COCRA Send Payment to: One Capitol Mall, Suite 320 Sacramento, CA 95814
If paying by credit card: Billing Address same as Home above Billing Address same as Work above
Credit Card Billing Information
First Name
Last Name
Billing Address 1
Billing Address 2
Billing City
Billing State
Billing ZIP
Billing Phone
Credit Card Number*
Exp. Date*
I authorize COCRA to rebill my credit card annually upon renewal of my membership dues.
Note: COCRA dues are based on a calendar year; therefore, new members' dues will be prorated accordingly. Dues/Sponsorship are 100% deductible. Legislative Fund contributions are nondeductible.
