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Membership Application and Agreement

You will need to scan an image (low resolution jpeg is fine) of your California State Identification Card, Passport, or Military I.D. and upload where prompted in the form.

Please fill out each field in the form below and click send.

Click here if you are not automatically prompted to the Membership Categories Order page after submitting the form.


 

I am applying for membership with California Liberty Alliance, and declare that the information I provide on this application is true and accurate, under penalty of perjury according to the laws of the State of California. Furthermore, in signing this agreement, I accept the following terms and conditions for membership with California Liberty Alliance.
• The name of the Local Chapter of California Liberty Alliance that I am affiliating with is:

Chapter Name

• I agree to inform my Local Chapter, and the State Chapter of California Liberty Alliance, of any change in my legal residence that would require me to affiliate with another Local Chapter, in accordance with the territories established by C.L.A. Chapter Agreements.

Your Legal Name

Date of Birth

Mailing Address

City, State, Zip Code

Preferred Phone Number

Preferred Email Address

Preferred Social Media

• I have provided a copy of the following legal form(s) of identification, showing my California residency.

Identification Number

Upload a copy of your Identification Card

• I am applying for Class-I Membership with California Liberty Alliance, under the following category(s) (choose at least one), and I agree to maintain timely payment of dues to the Local Chapter for every Category I apply for, in order to maintain good standing and access to the privileges of membership.

 Category 1 Yearly: $100 per year Category 1 Monthly: $10 per month Category 2 Yearly: $1000 per year Category 2 Monthly: $100 per month Category 3 Yearly: $2000 per year Category 3 Monthly: $200 per month Category 4 Yearly: $500 per year Category 4 Monthly: $50 per month Category 5 Yearly: $500 per year Category 5 Monthly: $50 per month Category 6 Yearly: $1000 per year Category 6 Monthly: $100 per month Category 7 Yearly: $1000 per year Category 7 Monthly: $100 per month

• If my membership is within any of the categories requiring qualified status under California laws, I agree to maintain my qualified status and to provide a copy of my current qualifying documents to the Local Chapter, so long as I am a member of California Liberty Alliance.
• I agree to abide by all policies and procedures of California Liberty Alliance, as they are established and posted on the C.L.A. Website, at the Local Chapter headquarters, or provided to me in writing.
• I agree to abide by California Liberty Alliance’s Non-Discrimination Policy, and to comport myself in a respectful manner at all times while engaged in activities associated with California Liberty Alliance, or while on the premises’ of any C.L.A. Chapters.
• I agree to comply with the laws of the State of California at all times while engaged in activities associated with California Liberty Alliance, or while on the premises’ of any C.L.A. Chapters.
• I acknowledge that the Board of Officers of California Liberty Alliance reserves the right to suspend or revoke my membership status, for cause (see Bylaws for more information).
• I understand that all dues paid to California Liberty Alliance are non-refundable.

Date Signed

By clicking the Send Button below, you agree to the terms and conditions outlined in this agreement.

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