ABATE of New York Inc. - Membership Application
State Office 888-344-4400
For your (and our) convenience, this application may be filled in online, then printed, as it requires your signature.
Send it (or bring to an ABATE meeting/event) along with a check or money order in the appropriate amount payable to:
New Member or Renewal 
Membership #:      Current Expiration:
ABATE of New York
111 Hampton Ave
Rensselaer, NY 12144
  Full Member $30 per year – Includes membership packet, newsletter, and all benefits in accordance
        with State By-Laws
  Associate Member $25 per year – Same benefits as a Full Member except no newsletter.
       This membership is available only to additional members of a Full Members household. 
  Life Member:  6-10  Years of being an ABATE Member -  $500
  Life Member:  11-15 Years of being an ABATE Member - $350
  Life Member: 16-24 Years of being an ABATE Member - $200
Name  Address 
City  State  Zip Code 
Chapter (County) Please select Member at Large if you
do not want to belong to a specific chapter.   		County - If not found in the list of chapters
 
Phone Number  Date of Birth
  		Newsletter Delivery
Email Post Office
Email Address 
Method of Payment :   Check              Money Order              Master Card              Visa

Visa or MasterCard Accepted:  Card Number    

Expiration Date (Month-Year) :    
I agree to comply with ABATE of New York's By-Laws, and to promote motorcycle education,
legislation, and activities in accordance with ABATE of New York, Inc.
Applicant Signature

______________________________________________
 Date