Professional Membership Application

Non-Profit organization involved with or interested in state-administered motorcycle safety programs.

2008 Membership Dues $1,000.00 January 1, 2008 through December 31, 2008

REQUIRED INFORMATION Organization:                                                                                      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 $1,000.00, 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