Long Island Beach Buggy Ass'n. Inc.
2008 Membership Application
Name
:___________________________________________________
Address :_________________________________________________
Phone: (Home) __________________ (Business)
________________
Affidavit :
I will uphold the code of ethics and abide by the
By-laws of the Long Island Beach Buggy Ass'n. Inc. at all times.
Signature:
______________________________________________
Date:___________________ LIBBA # (if applicable)
: _____________
If you are signing up a new member, enter your membership
# above.
Membership Dues:New
Membership Individual or Family $35.00
(Membership Renewal Dues:Individual or Family -$25.00 yr)