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Dan Langwell
C: (574) 904-9643 H: (574) 255-0992 |
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Dan Langwell wants every clown and entertainer to be the best they can be. This starts with education.
Learn the history of clowning. Find other clowns in your area or across the country. Enter a competition at an upcoming event.
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Indiana Regional Ambassador COAI.org: Clowns of America International 2002-present (Dan Langwell) Form Below SPONSOR: (COAI #26791 Dan Langwell) |
Membership Features: This and more! Join the fun: Calendar of events Ask about the new E-group too! |
Clowns of America International
Application & Renewal Form
NOTE: Family members must each fill out a form. This is a secure page. Look for the Lock symbol to assure this.
Personal Information provided to COAI is used only to establish, re-establish, update and/or verify membership information. Our membership list is not shared with outside organizations of any type.
* Required Fields!!
Visa MasterCard Discover Check/Money Order
Card Number:* ---
Card Verification Number: (On the back of your card, find the last 3 digits)
Click Here for help finding your Card Verification Number
Expiration Date:*
First Name:* MI: Last Name:*
Address:* Change of Address
City:*
State:* Zip:*
Country:*
Phone:* ()--
Date of Birth:* Age: Sex:M F
Email:*
Clown Name: Alley Affiliation(#):
Sponsor (COAI #):
Referred by: Dan Langwell (COAI #26791)
For Renewals: COAI #: Membership Expire Date:
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Annual Membership and Renewal Fees
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Indicate Amount Paying: $ |
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Renewal Active Member
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$25 |
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New Member US |
$35 |
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Family Membership (US & International)
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$12 |
New Member International (US Funds) | $30 | |
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Renewal International Member
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$30 | New Senior Member (65+ after 7/1/2004) | $25 | |
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Renewal Senior Member
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$20 | New Senior Member Intl. (US Funds) |
$30 |
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Renewal Senior Intl. Member (US Funds)
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$25 | New Junior Joey | $25 | |
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Renewal Junior Joey (US Funds)
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$20 | Lifetime Membership | $500 | |
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Web Ad
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$10 |
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Print out and mail or fax to: Fax: 1-888-52clown or 724-938-8765
SEND APPLICATION / RENEWAL TO:
Clowns of America International
P.O. Box C - Richeyville PA 15358-0532
Web: www.coai.org
Membership Application Instructions:
- Seniors and Junior Joeys may be required to present proof of age with application or renewal. Please call the business office for further details.
- Seniors must be age 65 or older within the enrollment or renewal year. Junior Joey must be age 8 to 15 in the enrollment year.
- Children age 8-15 can choose to join as family or Junior Joey… family members can be any age.
- Full members and Junior Joeys receive The New Calliope… family members do not.
- All memberships to COAI are on an annual basis with dues payable July 1 of each year.
- Join at the new member rate indicated any time of the year. If you wish to join COAI as a new member and the date is not June, July, or August, your membership will be prorated for the next year on the annual dues notice. When you receive your dues notice in May following your sign-up, the prorated amount you should pay to bring your membership up to July of the new membership year will be indicated on your notice.
** For example, if a US resident applied for a membership in October of 2003, he/she would have paid $30 to join and extend the membership to October 2004. In May 2004, the member will receive a prorated dues renewal notice for $20, to extend the membership from October 2004 to July 2005. Then each year after that the annual fee of $25 would be billed in May for payment by July 1st.
International and family memberships are similarly prorated.
Images Copyright © 2001 Clowns of America International. All Rights Reserved.