Member Application

Of the 169 local governments in the State of Connecticut, 142 are suburban and rural jurisdictions with 35,000 or less in population. Small towns are home to over a million state citizens and taxpayers. The Connecticut Council of Small Towns was founded in the belief that local government leaders from these smaller towns – and their residents – needed a strong voice within the legislative and regulatory decision-making arenas, both in Hartford and in Washington, D.C. Since its establishment in 1975, COST has provided that voice. Thanks for your strong support of COST, small towns and Connecticut’s grassroots governments!

Business Information

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Website:

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Business Description (2000 char max): *

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Comments / Questions:

Physical Address

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State: *

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Mailing Address

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Primary Contact Information

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

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Contact Preference:

Email Phone

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Social Networking:

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Address

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Billing Contact Information

Same as Primary Contact

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Password: *

Social Networking:

LinkedIn Facebook

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Membership Options

Membership Package: *

Population Level 1: $725.00
Population: up to 5,000 Population Level 2: $825.00
Population: 5,001 to 10,000 Population Level 3: $925.00
Population: 10,001 to 15,000 Population Level 4: $1,025.00
Population: 15,001 to 20,000 Population Level 5: $1,125.00
Population: 20,001 to 25,000 Population Level 6: $1,225.00
Population: 25,001 to 30,000 Associate Membership Dues: $795.00

Payment Option:

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