3C4A MEMBERSHIP APPLICATION: 2023-2024

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Community College Counselors / Advisors Academic Association for Athletics

Email *

First and Last Name
*

Application Type
*

New Member

Returning Member

Title *

Name of Institution
*

Two-year / Four-year
*

2 YEAR

4 YEAR

Other:

Address *

City *

State *

Zip Code

Office Phone
*

Employment Status
*

Full-time

Part-time

Numbers of Hours Allotted to Student-Athletes
*

Numbers of Hours Allotted to General Population
*

Membership Type
*

Primary Single Membership ($125)

Additional Membership ($100)

Please submit your payment via check (made payable to 3C4A) to the address below. Also include your name, your title, and the school you are affiliated with to ensure our treasurer is able to match checks with individual memberships. The deadline for continuous membership is October 31.

Angel Meraz

College of the Desert

43-500 Monterey Ave

Palm Desert, CA 92260

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

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