Application for Membership – Year 2006
ALFRED BUSINESS ASSOCIATION, INC.
Post Office Box 451, Alfred, NY 14802-0451
Dues: $100 per calendar year or $80 per year if paid by 3/31/06
Name:
_____________________________________ Title: _____________
Company: __________________________________ Phone: ______________
Mailing Address: ___________________________________________________
Village: ___________________NY _________
Please describe your business:
___ Retail ___ Mfgrs ___ Service ___ Professional ___ Other
ABA Group Insurance Participant: YES NO No. of Employees _____
website: _________________________________________________________
email: __________________________________@ _______________________
Amount enclosed: $ ___________ Check No. ________ Mail to above address
Dues Paid to:
Alfred Business Association, Inc.
Year: 2006
Amount: _________________
Date Paid: _____/_____/ 2006
Check No. ________________
Please detach for your records.
Thank You!
