Signup for Gold Star Membership

English / 日本語

Gold Star Member Pre-registration Form

Please ensure to read below notes before completing the form.

* This is pre-registration form for new members who have not canceled Costco membership in the last 12 months.

* Please visit membership counter at the nearest Costco warehouse to complete registration.

* You need to present one photo ID at the membership counter.

Primary Card

* …Required.
**…Minimum One telephone number required.

Nearest Warehouse*

Primary Member Name*

First Name

Last Name

Address*

Zip Code

－

Prefecture (Auto Input)

City/Town/Ward (Auto Input)

Address 1

Address 2

Home Phone Number**

Mobile Phone Number**

Email Address*

Re-enter Email Address*

Date of Birth*

Year:Month:Day:

Sex*

SexMaleFemale

Household Card　(Optional) *Spouse / Domestic Partner

A free Household card is available to a Primary cardholder’s spouse, domestic partner, or immediate family member over the age of 18 and living at the same residential address. Household cardholders will be asked to present proof that they live at the same address as the Primary cardholder.

Request Free Household Card

Please check the following item for confirmation.

I did not cancel Costco membership within last 12 months.

Submission of this application by clicking the "Accept" button shown below constitutes acceptance of Costco's Member Privileges and Conditions, and Privacy Statement.

Gold Star Member Pre-registration Form

Primary Card

Household Card (Optional) *Spouse / Domestic Partner

Please check the following item for confirmation.

Household Card　(Optional) *Spouse / Domestic Partner