CCA Membership Application

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The Congo Community Association Incorporate membership is open to ratepayers and residents of the Congo area, as outlined on the CCA website. If you are not a ratepayer or resident of Congo but have the Congo Community at heart, you can become a CCA Associate Member.

Email *

First Name *

Last Name *

I am a Congo *

Resident

Ratepayer

Resident and ratepayer

None of the above, but have a close association with Congo.

I'm not a resident/ratepayer of Congo, but

have family and friends in Congo.

surf at Congo Beach.

walk my dog at Congo Beach.

use the Congo campground.

Other:

Clear selection

Phone number *

Congo Street Address if a resident and/or ratepayer

Mailing address if different to Congo address or if not a resident/ratepayer

I want to take up the following membership: *

1 year membership - $10

2 year membership - $20

3 year membership - $30

Other:

Required

I wish to have my contact details suppressed if an inspection of the membership register is requested by another member. *

No - I don't want my contact details suppressed.

Yes - I want my contact details suppressed.

Required

I want to become a CCA member. I have read and agree to the terms and conditions of the CCA's Constitution and Privacy Principles as outlined on the CCA's website. *

Yes

Required

CCA Membership Payments

Payments for CCA membership subscriptions can be made via online banking or direct deposit.

Bank: CommBank
Branch: Moruya, NSW
Account Name: Congo Community Association Incorporated
BSB: 062-575
Account Number: 10261212

Please put your full name as the bank reference.

A copy of your responses will be emailed to the address you provided.

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