Add Spouse/Partner to Existing Membership

Cost to Add Spouse/Partner: Original/Classic +$1,000 • Bronze +$1,500 • Silver, Gold & Platinum – Included; no additional cost
Existing Member's Level*
(ORIGINAL LEVEL = those who joined when there was only one level of lifetime membership; equivalent to Classic level, but member ID# has prefix of “LT” followed by a 4 or 5-digit number, i.e. “LT12345”)
Existing Member ID#*

(This number is on your plastic or brass member ID card.)
Existing Member's Name*
Prefix First Middle Last Suffix
Existing Member's Email*
Enter Email Confirm Email
Spouse/Partner New Applicant Information
Spouse/Partner Applicant Full Legal Name (as listed on driver's license)*
Prefix First Middle Last Suffix
Preferred Name

(i.e. How you’d like to be addressed, nickname, etc.)
Gender*
- Male
- Female
Date of Birth*
Month
Day
Year

Must be at least 25 years old to apply.
Driver's License #*
Driver's License State of Issuance*
Last 4 Digits SS#*
Preferred Phone #*
Phone Type*
Email Address*
Enter Email Confirm Email
Business/Company Name
Business/Company Location – City & State
Business/Company Website

Billing & Payment Information
Billing address must match with associated credit card being charged.
Billing Address*
Same as Shipping Address

Street Address Address Line 2 City State ZIP Code

Must match credit card information.
Credit Card Information
Credit Card*
IMPORTANT: Address & Cardholder Name must match EXACTLY to credit card being used, or your transaction may be declined.

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Total Amount to Be Charged
$0.00
Thank you for applying! The applicant will be emailed a copy of this application form once submitted. Please allow approximately 10-12 weeks for delivery of any member items.

Once you have completed the Add Spouse/Partner to Membership form please mail or email the form with payment back to us. The background check approval process (5-10 business days) must still take place before the spouse/partner’s membership items are ordered. The current wait time between membership items ordered and delivered is approximately 6-8 weeks.
The fees to add a spouse/partner to your existing membership are as follows per level:
- CLASSIC (or orginal LIFETIME) MEMBERSHIP = $1,000 to add spouse/partner
- BRONZE = $1,500 to add spouse/partner
- SILVER, GOLD, PLATINUM = No additional payment is required as spouses/partners are included in these membership levels, however, the form must still be filled out for background check authorization and item selection. Please leave the payment section blank unless joining our monthly giving program at this time.

If you have questions or need assistance with this process please call our membership team at 714.529.1199 or email applications@chp11-99.org.

Spouse/Partner New Applicant Information