National Association of State Motorcycle Safety Administrators




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Supporting Associate Membership Application

Unincorporated organizations, entities or individuals participating in, coordinating with or interested in state administered motorcycle safety programs or motorcycle safety issues.

 2008 Membership Dues $500.00
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 $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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