COSCA 2018 MEMBERSHIP APPLICATION
**NOTE : Membership ends December 31st of the current calendar year **
Mail to:Shannon Dillinger 4710 Bryenton Rd; Litchfield, OH 44253 Phone :440-623-7343 E-mail :
BASIC MEMBERSHIP TYPES Handlers/Riders must be members of COSCA and the horse signed up for points in order for points to count. Email is required below for newsletters and communications.
INDIVIDUALTOTAL INDIVIDUAL ENROLLMENT$30 ______
NAME ______DATE OF BIRTH ______
ADDRESS______
CITY______STATE______ZIP ______
PHONE______EMAIL ______
FAMILYTOTAL FAMILY MEMBERSHIP $40______
ADDRESS______
CITY______STATE______ZIP ______
PHONE______EMAIL ______
FAMILY MEMBERS: Includes single children 17 years and younger living at home.
NAME ______DATE OF BIRTH ______
NAME ______DATE OF BIRTH ______
NAME ______DATE OF BIRTH ______
NAME ______DATE OF BIRTH ______
POINT FEE:***POINTS WILL BEGIN TO ACCUMULATE ONCE FEE IS RECEIVED**** APPLIES TO ALL YEAR END &HIGH POINT AWARDS.
HORSE______BREED______
HORSE______BREED______
HORSE______BREED______
If additional space is required please attach another form.
Total Number of Horses Enrolled: ______X $20TOTAL POINT FEE $______
CORRAL SUBSCRIPTION: If you would like to receive a yearly subscription to the Corral, all COSCA Members can now receive a subscription at a discounted price of $10.00. (Please check below)
Yes I would like a Corral subscription______No thanks______$10.00 per subscription
TOTAL CORRALSUBSCRIPTION $______
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SPONSOR A CLASS:Please consider sponsoring a class and support your organization! Sponsorship starts at $15 a class for our Benefit, Summer Sizzler, and Open shows.
Yes I would like to sponsor ______class(s) @ $15.00 each
TOTAL SPONSORSHIP $______
CERTIFICATE OF MERIT, CHAMPIONSHIP & SUPREME MERIT NOMINATION: There is a one-time fee of $10 per horse and $10 per rider to accumulate points in the COM program. Once enrolled the horse/rider will accumulate points on a lifetime basis. Refer to the COSCA rulebook for more information on the COM program.
RIDER/HANDLER: ______DATE OF BIRTH ______$10 ______
RIDER/HANDLER: ______DATE OF BIRTH ______$10 ______
RIDER/HANDLER: ______DATE OF BIRTH ______$10 ______
HORSE NAME: ______BREED:______AGE: ______$10 ______
HORSE NAME: ______BREED:______AGE: ______$10 ______
HORSE NAME: ______BREED:______AGE: ______$10 ______
TOTAL COM NOMINATION FEE $______
TOTAL MEMBERSHIP FEES $ ______
Please make checks payable to COSCA. COSCA no longer automatically mails every member the official rule book. To obtain a copy of the current COSCA rulebook you may request a copy from the Membership Secretary. The fee for a hardcopy is $10 and $5 for a CD in MS Word format. You may also download the rulebook at no charge online at