Coastal Carolina Letterwinners Association

Chanticleer Athletics

Membership Registration

$54 MEMBERSHIP DUES

Membership will expire June 15th each year.

* denotes a required field

Member Information

Name: *(first/middle/last)
Maiden Name:		Date of Birth: * (ex: 2/12/1984)
Spouse:
Degree/Major:		Graduation Date: * (ex: 5/2012)
If you did not graduate, please enter the last date you attended as your graduation date above.
Address: *
City: *	State: * Zip: *
Phone: *		Cell Phone:
Email: *

Work Information

Company:
Your Title:
Address:
City:	State: Zip:
Phone:
Email:
Preferred Contact: *	Home Work

*Would you (or your company) be interested in participating in an internship program for our current student athletes? Yes No

Sports Information

CCU Sport Played: *		Years: * (ex: 1985, 1986)
Coach: *
Other Sport Played:		Years:
Other CCU Coaches:

Professional Experience: (ex:, NFL, MLB, WMBA)

Other Information

If you have contact information on any former Coastal Carolina University student athlete or coach, please provide it here so we may contact them about the Letterwinners Association.

*Do you want your information shared with other Coastal Carolina Letterwinners Association members?
Yes No