AlaBike Membership Application & Renewal

Make check payable to “AlaBike”, Mail to:  AlaBike  P O Box 18984 
Huntsville, AL 35804

Contributions to AlaBike are Tax Deductible

p Active, $25.00                                  p Family, $40.00                     p Student, $10.00

p Non-Profit, $ _______          p Corporate, $50.00 or ________

Contribution Levels

p Domestique, $50.00 – $99.00                         p Gold, $250.00 - $499.00

p Silver, $100.00 - $249.00         p Elite, $500.00 - $999.00          p Champion, $1,000.00 plus

For persons joining under Corporate membership, please fill out information on this form and list Company here: ____________________________
A donation for membership is not required but always appreciated!

Name:  ____________________________ [   ] Male   [   ] Female  Date: _______________

Address:  _____________________________________________________________

City, State, Zip ________________________

Date of Birth: _________________________

Employer: ___________________________           Occupation: __________________________

Contact Phone:  (____) __________________

Email: _____________________________________________

May we release your name and address to bicycle clubs and other non-commercial cycling-related entities?  Yes _____ No ____  We never publish e-mail or phone numbers.

I am on my local CAC or Bike/Ped Comm____ I would like info about CAC/MPOs_____

This is a renewal, I completed the survey before_______

How many cyclists ___ and drivers ___ in household?

Estimated annual household cycling related spending: $_______

Type of cyclists in household:

___Commuter

___Competitive/Racing

___Fitness                               

___Off-Road

___Recreational Road              

___Touring

___Utilitarian (errands…)         

___ Children

___ Other

I would like to help Alabike by:

___Staff a booth or volunteer at regional events

___Contacting government/legislative officials

___Education

___Administrative/mailing

___Local leadership or coordination

Club Affiliation (Please circle your club, if applicable.): 

• North-East Alabama Bicycle Club (NEABC) (Anniston)
• Spring City Cycling Club (SCCC)  (Huntsville)
• Birmingham Bicycle Club (BBC)
• GCC (Birmingham)
• Birmingham Urban Mountain Peddlers (BUMP)
• Montgomery Bicycle Club (MBC)
• Druid City Bicycle Club (DCBC) (Tuscaloosa)
• East Alabama Cycling Club (EACC) (Auburn)

Other ___________________

Comments:____________________

AlaBike  P O Box 18984 
Huntsville, AL 35804