To become an active member of ABATE of California, print out this form and mail the completed form to:
ABATE Local 6 P.O. Box 178013 San Diego, CA 92177
| Name: |
| Address: |
| City: |
| State: |
| Zip: |
| Phone: |
New Renewal - Local# ________
ABATE Membership # ______________
Patch or Pin recieved? Yes Not Yet
MEMBERSHIP (Circle One)
|
Type
|
Single
|
Couple
|
| One Year | $30.00 | $50.00 |
| Life | $450.00 | $650.00 |
| Gold Business | $125.00 | |
| Gold Business with color | $200.00 per year | |
|
Credit Cards Accepted
|
| Visa Mastercard Exp. date ____________ |
| Card# |
| Signature |
Membership submitted by Local#6 Website