Orange County Ca Death Certificates - DOC

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					                           OCCAC Membership Application
Print and fill out the application below. Mail the completed application, enclosed with a check for $37
payable to the Orange County CAC, to the OCCA C c/o Maureen Van De Moere, 3055 Capri Lane, Costa
Mesa, CA 92626-3551. (If you are a member o f another CA C, p lease specify which one and include it with
a check for $27 and include a current copy of your membership card for a reduced fee.)

Full members must have a four year degree. Associate/Equivalent members must have two y ears of college
with related work experience or an equivalent. Subscriber members do not meet any of the above or are
not free to marry in the church. Meeting these requirements does not guarantee approval for membership,
all applicat ions for membership must be approved by the OCCAC board

Please print legi bly. All information is kept strictly confi denti al. Renewing members need only fill in
name and update address and phone and other changes.

Renewal____ New____ How d id you hear about us? __________________________________________

Full____ Associate/Equivalent____ Subscriber Member____ Dance Info Only (this option is free) ______

Name_____________________________________________ Date of Birth___________ M/F__________


City______________________________________________ State_________ Zip Code_______________

Telephone (      ) ___________________ Email________________________________________ _______

College Attended____________________________ Year Graduated _____________Degree___________

Other Degrees/Cert ificates ___________No degree, but meets other requirements (State your experience)


Catholic? Yes___ No___ Parish (including city) ______________________________________________

Never Married____ Widowed____ Divorced____ If divorced is your marriage annulled? Yes____ No____

(A copy of your Annul ment or Lack of Form must be included if applying for a Full or
Associate/ Equi valent membershi p. All prior marriages must be formally nullified for Full or
Associated/ Equi valent memberships. There are no canonical exceptions in compli ance with CACI
rules. This applies to marri ages outside of the Catholic Church, and if one or both parties were not
Catholic at the time of the marriage.)

What Diocese?________________________________________Date______________________________

Because the OCCAC is a nonprofit organizat ion, we rely on members to volunteer and sponsor many of the
events on the calendar. Please circle those CAC committees or events to which you may be interested in
volunteering for:

Board Members/       Dance                 Sports                Relig ious Events     Hospitality
 Officers            Game Nights           Camp ing              Ho me Masses          Photography
Membership           Dinner and Movies     Hiking                Co mmunity            Fundraising
 Drives              House Parties         Picnics                Serv ice             Parish Reps
Newsletter           Cultural              Travel                Charity               Telephone Tree
Publicity            Theater                                     Conferences           Co mmunicat ions
I certify that I am 21 years of age or older and to the best of my knowledge, affirm the above information is
complete and correct. I understand that an incomplete application and/or falsificat ion of any information
will result in voiding of this application, the forfe iture of any fees paid, and my membership revoked.

I shall follow all rules and regulations of the OCCA C as stated in the CAC Constitution and By -laws.
Upon failure to co mply with these rules, the CAC and OCCA C reserve the right to terminate my
membership at anytime and forfeiture of all fees. This includes behavior that is deemed inappropriate to
other members.

I understand that certain activities sponsored may be dangerous to my health and/or life. I hereby for
myself, my heirs, executors, and administrators, waive and release any and all rights and claims that we
might have, or that might arrive against the CACI/CA C/OCCAC, its agents or representatives, for any and
all in juries, death or losses sustained by me wh ile participating in events sponsored by the club.

I hereby authorize the Orange County Catholic Alu mn i Club (OCCA C) to verify the above informat ion.

Signature_____________________________________________________ Date ___________________ _

FOR OFFICIAL US E ONLY Exp:_____/______ Proc:______/______ Inq: ______/_______

Description: Orange County Ca Death Certificates document sample