CCKS Membership Application

1 Year Family Membership for the Central California Koi Society (CCKS) is $40

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Member 1 Name *

First

Last

Member 2 Name

First

Last

Member 1 Email *

Email

Confirm Email

Member 2 Email

Email

Confirm Email

Phone Number *

Street Address *

City *

State *

Zip Code *

Do you have a koi pond? *YesYesNoNot yet

Do you want your phone number listed on the roster? *YesNo

The CCKS email newsletter is automatically sent to all members. Do you wish to Opt Out of receiving the email newsletter? *Opt-in NewsletterOpt-out Newsletter

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For more information please contact Rosimeri Tran at (559) 970-8508 or cencalkoi@gmail.com