2025 KOA OA Membership Form

KOA NAME*

Main Contact Name (Person we should send membership information to!)*

Main Contact Phone/Offseason Phone (Best number to reach main contact regarding membership information)*

Please enter a valid phone number.

This email will be used for ALL office communication, newsletters, membership updates, benefits information, etc!*

example@example.com

Campground Mailing Address:

Franchise Number*

If you do not have your Franchise Number, please reach out to KOA, Inc.!

Brand Type*

ResortHolidayJourneyNet Yet Branded

Camper Nights*

Campground Email

example@example.com

Campground General Phone Number

Please enter a valid phone number.

Website

IF YOUR BILLING / ACCOUNTING CONTACT information differs from the MAIN CONTACT listed above, please include all of that information here! You can also include any notes for the office here. You can list "N/A" if this does NOT apply to you!

Please choose only ONE level of membership below with the corresponding campers nights that matches your total!

REMINDER: New Members pay only $75 and DRF Donations are tax deductible as they are ran through the Disaster Relief Foundation.

Membership Level

NEW Member: $75.00 USDCamper Nights between 0-7,500: $150.00 USDCamper Nights between 7,501-12,500: $300.00 USDCamper Nights between 12,501-17,999: $450.00 USDCamper Nights between 18,000-24,500: $600.00 USDCamper Nights 24,501+: $750.00 USD

I would like to make a TAX DEDUCTIBLE donation to the Disaster Relief Foundation! To pay online for this and your membership, choose the CREDIT CARD option below and add the donation amount to your cart!

Enter Amount of Donation above.

PAYMENT METHOD: HOW I WOULD LIKE TO PAY!

BY CHECK: mailed to PO Box 228, Ettrick, WI 54627 (USA) or Susan Marcoux at 1000Islands/Mallorytown KOA, 1477 County Road 2,PO Box 29, Mallorytown, ON K0E 1R0 (CANADIAN). Complete the check number field below!BY PHONE: Call (608) 525-2323 and have your completed form ready to read to the office staff, OR, email it to: info@koaowners.org.BY CREDIT CARD: Complete the payment options in the cart below!SEND ME AN INVOICE: Complete that field below!

CHECK

INVOICE ME at this email via QuickBooks:

example@example.com

SIGNATURE

Send completed form and payment to: "KOA OWNERS ASSOCIATION."

Remit to: KOA OA Office at PO Box 228, Ettrick, WI 546247.

You can also scan/email the completed form to: info@koaowners.org or tina@seversonandassociates.com.

Send your completed form and payment to: "KOA Owners Association" in Canadian currency.

Remit to: Canadian Assistant Treasurer, Susan Marcoux at 1000 Islands/Mallorytown KOA, 1477 County Road 2, PO Box 29, Mallorytown, ON KoE 1Ro.

You can also scan/email the completed form to: info@koaowners.org or tina@seversonandassociates.com.

CART FOR ONLINE PAYMENT WITH CC ONLY - If you'd like to pay another way, please adjust your payment method above!

NEW MEMBER - Applies to first year of Membership ONLY! Product Image

NEW MEMBER - Applies to first year of Membership ONLY!Choose this membership level if you are a NEW OWNERS of your KOA! Rate applies only to the first year of membership & REMINDER: No matter your level, we need your camper nights - don’t forget to fill them out above!

$75.00

RENEWING MEMBERS: Camper Nights between 0-7,500.Choose this level if your camper nights range between 0-7,500.

$150.00

RENEWING MEMBERS: Camper Nights between 7,501-12,500. Product Image

RENEWING MEMBERS: Camper Nights between 7,501-12,500.Choose this level if your camper nights range between 7,501-12,500.

$300.00

RENEWING MEMBERS: Camper Nights between 12,501-17,999. Product Image

RENEWING MEMBERS: Camper Nights between 12,501-17,999.Choose this level if your camper nights range between 12,501-17,999.

$450.00

RENEWING MEMBERS: Camper Nights between 18,000-24,500. Product Image

RENEWING MEMBERS: Camper Nights between 18,000-24,500.Choose this level if your camper nights range between 18,000-24,500.

$600.00

RENEWING MEMBERS: Camper Nights 24,501 or more. Product Image

RENEWING MEMBERS: Camper Nights 24,501 or more.Choose this level if your camper nights are 24,501 or greater!

$750.00

Disaster Relief DonationYou're welcome to donate any amount you're comfortable with - suggested donation is $100.00. Choose your "quantity" below If you'd like to donate a different amount other than those offered, please email the office at info@koaowners.org and we will get you a customized invoice!

$1.00 Quantity

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

HOW DO I FIND MY CAMPER NIGHTS?

Please choose only ONE level of membership below with the corresponding campers nights that matches your total!

REMINDER: New Members pay only $75 and DRF Donations are tax deductible as they are ran through the Disaster Relief Foundation.

U.S. MEMBERS

CANADIAN MEMBERS