Membership Application

Part 1: Membership Application - Statement of Agreement
I wish to enroll in the Orange County Employee Benefits Council. I consent to be governed by the by-laws of the Council. The by-laws state that this Council is to be comprised of persons who are productively, substantially and continuously engaged in the work in the field of employee benefits and who wish to be associated together to interchange information, advance knowledge and education, and foster sound principles, procedures and practices in the field of employee benefits.
By checking this box, I agree to the above mentioned statement for application.*
- I Agree

Part 2: Membership Information
Name*
First Last
Title
Company*
Company Address*
Street Address Address Line 2 City State ZIP Code
Phone - Work*
Mobile*
Consent to receive 2 text messages per month from OCEBC?*
- Yes
- No
Email*
Your email address will be your username for online access to members only sections of our website.
Password*
Enter Password Confirm Password

Overview of Fees
Annual Membership Dues*
- Prorated 2021 Membership ($50.00)
Benefits include annual membership from January 1, 2021 through December 31, 2021, and members only webinars. Additional fees will apply for Breakfast Meetings and other social events.
Total
$0.00
Billing Address
Street Address Address Line 2 City State ZIP Code
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name

Part 1: Membership Application - Statement of Agreement