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Membership Application Form
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General Information

This application is for the following type of membership. *
Is this application New or a Renewal? *
Membership Type
New or Renewal
The number of members your organization represents is very important. The number you enter into this field will determine your membership fees. Fees are based on the table you see to the right. This number will also determine how many voting delegates you may name. These delegates will be invited to Delegate meetings held usually the second Friday of each month except July and August.
Membership Fees:

  • $25 (Less than 50 members)
  • $50 (51 to 100 members)
  • $70 (101 to 150 members)
  • $100 (151 to 250 members)
  • $140 (251 to 500 members)
  • $200 (501 to 1000 members)
  • $300 (1001 to 2500 members)
  • $400 (2501 to 5000 members)
  • $500 (over 5000 members)
Is this the Organization mailing address or a Personal address?
This email address will receive confirmation of membership. You can designate a contact person below and they will be added to our mailing list, but in order to ensure completed membership applications, this address will receive email confirmation.

Contact Person

Create Account Login

Please create a web account below. It will allow you to log back into the web site and manage your account. It will also make the process of renewing your membership quick and easy. (Creating an account is optional. If you don't so today, you will be invited to do so by email at the time of membership renewal.)

This may be the same email address as any other contact on this form. Please confirm by entering it again here.

President Information

Treasurer Information

Delegates

Affiliates are entitled to send delegates to COSCO Council meetings in accordance with the size of their membership as follows:

  • Up to 250 Members (1 Delegate)
  • 251-500 Members (2 Delegates)
  • 501-1000 Members (3 Delegates)
  • 1001-2000 Members (4 Delegates)
  • Over 2000 Members (5 Delegates)
Add Another Delegate Remove

Payment Information

$
This field is automatically calculated based on your membership number entered above.
Membership Fee (Individual)
$
Add a donation to your membership fees and pay in a single transaction.

$
This amount will be charged to your credit card if you have chosen "Credit Card" as your payment method. Please remit this amount on your cheque, if paying using that method.
I would like to pay by
To pay by cheque, please remit to:

Council of Senior Citizens' Organizations of BC (COSCO)
Attn: Membership Secretary
Box 81131. Burnaby South, Burnaby, BC
V5H 4K2

You will receive an email copy of this application. At the top of the email is your application number. Please note the application number on your cheque, or print the email and include it in your envelope.

First Name
Last Name
Billing Address
Billing Address
City
Province
Zip/Postal
Country
Credit Card

Refund Policy Agreement

I have read and agree with the refund policy.

Administration Area

Membership Approved?
Membership Status

Renewals

Renewal Approved?
Add Remove

Payment Tracking

Payment Method
Payment Method
Add Remove

Payment Status

Notes