COTPC Membership Form

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In order to receive points in the COTPC there is a $125 annual fee per truck. Once the fee is paid a
number will be issued. That number must be put on the driver’s side front window. The number goes
with the truck not with the driver. ALL Fields are REQUIRED!

Email *

COTPC Number - A number will be issued if you do not currently have one. *

Full Name (as it reads on tax forms) *

Class Selection - you can choose more than one class. *

8000# Workstock Diesel

8000# Light Pro Stock Diesel(2.6)

6200lb Light Pro Street Gas

6500lb Pro Street Gas

8000lb Limited Pro Stock Diesel(3.0)

6350lb Modified Gas

8000lb OPEN

6500# Limited Street Gas

Required

Truck Make & Model *

Truck Color *

Truck Name *

Address *

City, State, Zip *

Email Address *

Cell Phone Number *

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