National Association of State Motorcycle Safety Administrators




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 Corporate Membership Application

For-profit entity involved with or interested in state-administered motorcycle safety programs.

 2008 Membership Dues $1,500.00
January 1, 2008 through December 31, 2008

  REQUIRED INFORMATION

Company Name:                                                                                                              
Representative's
Name:
 
Address:  
City:  
State:  
Zip Code:  
Phone:  
Email:  

Providing your email address is very important as we communicate with our membership largely by email. 

Print this form and mail with your check in the amount of $1,500.00, payable to SMSA to:

SMSA Business Office
7881 S. Wellington Street
Centennial, Colorado  80122-3193

For additional information, please call 303-797-2318
Fax:  303-703-3569
Email:  smsabusinessmgr@smsa.org
 
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