HEART OF ILLINOIS CHAPTER

Printable copy of Application

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By joining A.BA.T.E., you can be a part of a political power that has come together to oppose anti-motorcycling legislation and to promote the safety of motorcyclists. You can help support the implementation of programs that will help the sport of motorcycling.

Stand and be heard, join A.B.A.T.E. for more information and start taking action to control your own destiny. We can accomplish even more that we already have, if we put forth a concerted effort, gaining momentum as our membership grows. Your fellow riders need your help, and you need theirs.

Remember, one person does make a difference, but a group "focused on the same vision" is a force to be reckoned with and respected. We have proven that many times over, but the job is never done. You can help yourself as well as countless others, and all it takes is a membership application and a little time. Stand with us and be heard.

A.B.A.T.E. of ILLINOIS MEMBERSHIP APPLICATION

New Member (1) _________ (2) _________  Renewal (1) ________ (2) _________ Membership # (1) ____________________  (2)  __________________________ Date____________________
Original Date Joined (if renewal) (1) _______________________ (2) _______________________

Chapter Preference if different that Heart of IL. Chapter __________________________________

Name (1) _____________________________________________________________________

Name (2)_____________________________________________________________________

Address _____________________________________________________________________
City ____________________________________ State ________________ Zip ____________

Phone (________) ____________________________ County  __________________________  E-Mail address (1) _____________________________________________________________

E-Mail Address (2) _____________________________________________________________
Congressional District ________________ Senatorial District ____________________________
Representative District ________________ Registered Voter (1) ___________ (2)_____________

Date of Birth (1)___________________________ (2) __________________________________
Occupation (1) ____________________________(2) __________________________________
Completed a MSF Course (1)__________________ (2) _________________________________ Where did you hear about ABATE?________________________________________________________

MEMBERSHIP & RENEWAL FEES:  ___ $25.00 PER YEAR SINGLE  

                                                          ___$45.00 PER YEAR COUPLE.

MONEY SAVER SPECIAL:                 ___ $100.00 - 5 YEARS/SINGLE

                                                         ___ $180.00 - 5 YEARS COUPLE

ABATE-PAC SUPPORT:     ___ Add $1.00 per year to above dues amount to support legislative contributions.\

*** $2.00 of each members dues is allocated to lobbying expense and $1. is donated to the Motorcycle Riders Foundation (MRF).***

MAKE CHECK PAYABLE & MAIL TO:

HEART OF ILLINOIS CHAPTER of A.B.A.T.E.

Mail to:    Ruth Biddle     606 W. Wood St.,  Bloomington, IL 61701        309-828-3468                

MUST BE 18 TO JOIN

I understand that A.B.A.T.E. of Illinois cannot assume responsibility for my safety and that if I participate in any sanctioned event, I do so voluntarily, assuming all risk, I release and hold A.B.A.T.E. harmless for any injury or loss to my personal property which may result therefrom. I understand this means that I agree not to sue A.B.A.T.E. for any injury resulting to myself or my property at any event. I agree to comply with the bylaws and act in the best interest of A.B.A.T.E. of Illinois. A copy of ABATE-PAC's report is or will be filed with the State Board of Elections, Springfield, IL

Signatures (1) ____________________________________________________
(2) _____________________________________________________________

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