BSRA Membership Application
This page has been designed without images or frames for easy printing.
To apply for membership, please print out this page, fill out all applicable information, and mail the completed application and payment to the address at the bottom.
Thank you, and WELCOME TO THE B.S.R.A.!


Name: __________________________________________________________

Mailing Address: __________________________________________________

________________________________________________________________

City: _________________________________ State: ___________ Zip: ____________

Phone: (___________) ______________ ___________________

E-Mail: __________________________________________________________

Occupation: ___________________________________ Age: ______________


DESIRED MEMBERSHIP TYPE (Check One) :
____ Regular Membership ..................................... $ 25.00
____ Intermediate Membership (under age 18) ........ $ 20.00
____ Associate Membership .................................. $ 20.00
____ Roll Sign Subscription ................................... $ 16.00
Additional postage charges apply outside the United States; please contact us for current rates.
International subscription payments must be made by an international postal money order or by a check on a U.S. bank.

ADDITIONAL TAX-DEDUCTIBLE* DONATION:
____ 5706 Fund ............................................. $ _________
____ General Fund ......................................... $ _________
_____ PLEASE CLICK HERE IF YOU DO NOT WANT A TAX-EXEMPTION RECEIPT MAILED TO YOU.
All donations (but not dues) are federally tax-deductible. A receipt will be mailed for all donations, unless requested otherwise.

PLEASE SEND ME:
____ Current BSRA Publications Catalogue
____ List of available back issues of Roll Sign
____ Information on volunteer opportunities


Please mail this application, with your check or money order, to:

BOSTON STREET RAILWAY ASSOCIATION
P.O. BOX 181037
BOSTON, MA 02118-0011