Membership Application | Coast Guard Chief Petty Officers Association

Membership Dues

Your Dues Rate Type is: Enrollment Application for CGEA Regular Members - Allotment $0.00

Contact Information

Civilian Email *

Re-enter your email *

Rate/Rank *

First Name *

Middle

Last Name *

Suffix

Preferred/"Go By" Name

Address (incl. Apt if applicable) *

Address Line 2

Address Line 3

City *

State *

Zip Code *

Country

Preferred Phone *

CCMail

Include me in Membership Directories *
Yes No

Include me in Broadcast Email *
Yes No

Username/Password Username/Password

Please enter the Username/Password you would like to use to login to this website.

Your Username must be unique and must be at least 6 characters.
Passwords must be a minimum of 8 alpha-numeric characters with at least 1 number or 1 letter.

Username *

Password *

Confirm Password *

Payment Details

Total Amount Due

$

Payment Method

Enter the name on the bank account according to the information shown on your bank statement. The account number and routing number can be copied from the lower left corner of the check.

Account Type

Checking

Savings

Routing Number

Account Number

Account Holder Type

Business

Personal

Business Name

Account Holder Name

By submitting payment, I am authorizing Coast Guard Chief Petty Officers Association to initiate a single or recurring ACH/electronic debit in the amount indicated from the bank account I designated above. I understand that this Authorization will remain in full force and effect until the transaction is cancelled by me by contacting Coast Guard Chief Petty Officers Association , or the ACH/electronic debit is processed from the designated account. I certify that (1) I am authorized to debit the bank account above and (2) the ACH/electronic payment I am authorizing complies with all applicable laws.

Name on Card

Card Number

Expiration

CSC

Billing Street

Billing Zip Code

Save payment method for future purchases

Enable Automatic Renewals? *

Select "Yes" to enroll in automatic membership renewal. The payment method submitted with this form will be used for your future membership renewals. You can change the automatic renewal setting or saved payment method at any time in either the "Payment Methods" or "Renewal Settings" where you edit your profile.

Yes

No

CGEA Regular Member (Allotment Enrollment)

USCG Members Only

To cover your annual national dues on allotment:

Fill out the CPOA Regular Member (Allotment Enrollment) application

Log in to DA and start your allotment for CPOA /CGEA Assoc beginning the 1st of the next pay month for $4 per month (you must complete this step; we are not connected to DA)

Once we receive notification from PPC that your allotment has started, we will issue your CGEA membership credentials.

Membership Dues

Contact Information

Username/Password Username/Password

Additional Information

Additional Options

Payment Details

U.S. Coast Guard Chief Petty Officers Association

In Respect For Those Who Have Gone Before Us, And As A Guide For Those Who Follow

CGEA Regular Member (Allotment Enrollment)

USCG Members Only

To cover your annual national dues on allotment:

Fill out the CPOA Regular Member (Allotment Enrollment) application

Log in to DA and start your allotment for CPOA /CGEA Assoc beginning the 1st of the next pay month for $4 per month (you must complete this step; we are not connected to DA)

Once we receive notification from PPC that your allotment has started, we will issue your CGEA membership credentials.

Membership Dues

Contact Information Contact Information

Username/Password Username/Password

Additional Information Additional Information

Additional Options Additional Options

Payment Details Payment Details

U.S. Coast Guard Chief Petty Officers Association

In Respect For Those Who Have Gone Before Us, And As A Guide For Those Who Follow

Contact Information

Additional Information

Additional Options

Payment Details