APPLICATION FOR RENEWAL

CONCERNED BIKERS ASSOCIATION/ABATE OF RANDOLPH COUNTY NC, INC.

PLEASE PRINT AND MAIL TO:  

CBA/ABATE of RANDOLPH COUNTY NC

MEMBERSHIP SERVICES

PO BOX 817

Asheboro, NC 27204

 

 

NAME (S) ____________________________________________________________________________

 

ADDRESS:___________________________________________________________________________

 

CITY:___________________________________STATE:________ZIPCODE+4 ____________________

 

PHONE ( )_________________ E-MAIL ADDRESS _____________________________________

 

OCCUPATION:____________________________________________________ AGE: ______________

 

OTHER MOTORCYCLE AFFILIATIONS ___________________________________________________

 

ARE YOU A REGISTERED VOTER? Yes_______ No _________

 

Your continuing membership is valued. As a member of CBA, your ideas, suggestions and comments are important to our organization.

 Your comments will be used anonymously to implement and improve current and future programs within the organization.

 

 

 

I UNDERSTAND BY SIGNING MY NAME TO THIS APPLICATION THAT I AM RENEWING MYMEMBERSHIP INA GRASSROOTS POLITICAL

ORGANIZATION FORMED TO PROTECT MOTORCYCLIST’S RIGHTS.

SIGNED:__________________________________________________________DATE:_________________

 

 

Annual Renewal Dues: _______ Individual $25.00 _______ Couple $35.00

 

 Membership renewals must be returned with payment as soon as possible to prevent a lapse in membership. Renewal applications and dues MEMBERSHIP SERVICES ONLY 

 

:postmarked:______________received:________________by email –fax –mail sent to State –chapter_________________Pymt.method______________amt______________expiration

 

 date:_______________renewal card mailed:________________RENEWAL DATE _______________CHAPTER: ______________________“AT LARGE”MEMBER

 

MAIL APPLICATION WITH PAYMENT TO:CBA/ABATE OF NCMEMBERSHIP SERVICES P.O. Box 817 Asheboro, NC 27204

may be submitted to your local chapter or mailed to this Membership Services address.