2017 COTPC Membership Form
In order to receive points in the COTPC there is a $100 annual fee per truck. Once the fee is paid a
number will be issued. That number must be put on the driver’s side front window. The number goes
with the truck not with the driver. ALL Fields are REQUIRED!
COTPC Number - A number will be issued if you do not currently have one. *
Your answer
Full Name (as it reads on tax forms) *
Your answer
Class Selection - you can choose more than one class. *
Required
Truck Make & Model *
Your answer
Truck Color *
Your answer
Truck Name *
Your answer
Address with City, State, Zip *
Your answer
Email Address *
Your answer
Cell Phone Number *
Your answer
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