***THIS OFFER IS VALID ONLY IF YOU JOIN ABATE of California LOCAL 36***
$5.00 OFF MEMBERSHIP APPLICATION FORM
Print and complete this coupon to become a member of ABATE Local 36 of Palm Springs

 NEW MEMBER   RENEW Local 36 mem. # ___________

TYPE OF MEMBERSHIP
 NAME:
 Single (1 year) $25 $30
Couple (1year) $45 $50
 NAME #2: (If Couple or Business Application)
 Single (LIFE) $445 $450
Couple (LIFE) $645 $650
 ADDRESS:
 Gold Business $120 $125
 with business card ad
 CITY, STATE, ZIP CODE
 Gold Business $195 $200
 with COLOR biz card AD
 PHONE:

 E-Mail Address:

Make Check Payable to:
ABATE

Mail to:
ABATE Local 36
P.O. Box 460
Rancho Mirage, CA
92270
 DO NOT SEND CASH
 Payment Method: Personal Check Money Order
 Charge my credit card: MasterCard Visa
 Credit Card#
 Expiration Date:
 Credit Card Signature:
 Are you a registered Voter? YES NO
 Did you receive a patch (new members) or a year pin (renewals) TODAY? YES NO

 Membership submitted by:

 

PLEASE PRINT THIS FORM AND MAIL WITH PAYMENT TO:
ABATE Local 36
P.O. Box 460
Rancho Mirage, CA  92270
Attention: Membership

Copyright © 2005 ABATE of California. All rights reserved. Revised: November 04, 2005
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