1)Fill out the below included electronic form, press submit (Bea will receive as email) then please do one of the following;

1a) snail mail membership dues to LIBBA PO Address included or

2) Print this page, fill out the included form by Pen and mail back to address included with membership fee

L.I.B.B.A.

P.O. Box 816

Patchogue, N. Y. 11772

If you have any questions regarding your dues, fees, or anything, please contact Bea at 631-902-6049 or email to BAITRUNNER1101@LIBBA.com.

Thank You,
Bea #1101
Membership Director

Long Island Beach Buggy Association

                Membership Application & renewal Application

Name: _________________________________________________ 

Address: _______________________________________________

____________________________________________________

Phone: ______________________Cell:____________________

Email: ______________________________________________

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: _____________________________________________

Sponsored by: ___________________________________________

Office Use Info

Date: ___________________ LIBBA # given: __________________

New Membership - Individual or Family $35.00

Renewal Membership- Individual or Family $25.00

Seniors - 65 & older $10.00 with proof of age

Send Your Application Along With Your Check or Money Order To:

 L.I.B.B.A.

 P.O. Box 816

 Patchogue, NY 11772