2024 California Cooperative Conference
Registration Form
Friday, May 31 - Saturday, June 1
Liberty Station Conference Center in Point Loma
2600 Laning Road, San Diego, CA 92106
More information about the conference's workshops, speakers, registration, sponsorships, and membership can be found on our website:
www.cccd.coop
Questions? Contact us at info@cccd.coop or 530-297-1032.
We are looking forward to cooperating with you at the conference!!
Your Contact Information
First Name
Last Name
Email Address
Phone
Your Co-op/Organization Information
Co-op/Org Name
Co-op/Org Email Address
Co-op/Org Phone
Co-op/Org Website
Co-op/Org Sector
Role in Co-op/Org
Registration
($30 discount for CCCD members)
I am a current member
Yes - Individual
Yes - Organizational
No
I would like to renew my membership
Yes
No
I would like to become a member
Yes - for my co-op or organization
Yes - as an individual
No
Please choose your membership level
Annual Co-op/Org Revenue $1 billion & above: $750 / yr
Annual Co-op/Org Revenue $100 million - $999 million: $500 / yr
Annual Co-op/Org Revenue $3 million - $99 million: $350 / yr
Annual Co-op/Org Revenue $1 million - $2.9 million: $250 / yr
Annual Co-op/Org Revenue $700 thousand - $999 thousand: $200 / yr
Annual Co-op/Org Revenue $400
thousand - $699 thousand: $150 / yr
Annual Co-op/Org Revenue $200 thousand - $399 thousand: $100 / yr
Annual Co-op/Org Revenue Less than $200 thousand: $50 / yr
Please choose your membership level
Individual A: $200 / yr
Individual B: $150 / yr
Individual C: $100 / yr
Individual D: $50 / yr
Conference Session
Full Conference (May 31 & June 1)
Fri May 31 ONLY
Sat June 1 ONLY
Meal Preference
Meat okay
Vegetarian
Vegan
Gluten-free
Continuing Education for Attorneys - MCLE Credit
($25 for one or both days)
Yes
No
Conference Fee
$
Membership Discount
$
Membership Fee
$
Additional Attendees
I would like to register additional attendees ($20 discount for each additional attendee from same co-op/org)
Yes
No
Additional Attendee Contact Information
First Name
Last Name
Email Address
Phone
Choose Session
Full Conference (May 31 & June 1)
Fri May 31 ONLY
Sat June 1 ONLY
Meal Preference
Meat okay
Vegetarian
Vegan
Gluten-free
Continuing Education for Attorneys - MCLE Credit ($25 for one or both days)
Yes
No
Additional Attendee
Conference Fee
$
Additional Attendee
Membership Discount
$
Total Costs
Total Amount for Your Registration
$
Payment Information
Name on Card
Visa or MasterCard Number
MM
YY
Code
Cardholder Billing Email
Contact Information