PBA APPLICATION FORM
MEMBERSHIP APPLICATION/RENEWAL FORM, Year 2008
PENNSYLVANIA BOATING ASSOCIATION, Inc.
Incorporated 1966
Your name/organization ________________________________________________ Date __________
(please print)
MEMBERSHIP TYPE Individual ____ *New ____; **Renewal ____; ***Life ____; ****Dealer ____;
(***previously enrolled)
(please check applicable category or categories)
MEMBERSHIP FEE SCHEDULE
_____ Individual
$7.00;
_____ Club/Association $36.00;
(calendar year)
(calendar year)
_____ Comm./Dealer $36.00;
_____ Life Member
$100.00;
(calendar year)
(individual members only – one time payment)
(please choose only one)
Amount Enclosed ______ please no cash; Make check or money order out to PA Boating Assn.
Your/Org Address ____________________________
Yaht Club Affiliation ________________________
(if any)
City _______________________________________
Address __________________________________
State _____________________ Zip ___________
State _______________________ Zip ___________
Email Address __________________________________________________________________________
THANK YOU FOR YOUR SUPPORT IN BEHALF OF ALL RECREATIONAL BOATERS IN THE COMMONWEALTH
Send to:
PA Boating Association
P.O. Box 810
Bryn Athyn, PA 19009