Voting Membership Application

State Motorcycle Safety Programs - Person or entity recognized and/or funded by a state, any branch of the United States Department of Defense or the United States Coast Guard, whose responsibilities include the administration of a statewide or military-wide motorcycle safety program.

Membership Effective January 1, 2008 - December 31, 2008  CATEGORY:  PROGRAM BUDGET:  DUES:  CHECK ONE:  Category I  <$125,000  $500    Category II    $125,001 - $400,000  $1,000    Category III  >$400,001  $1,500

REQUIRED INFORMATION State Name:                                                                                                            Agency:   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 form and mail with your check in the amount determined above, 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