HELP MAKE LOS ANGELES COUNTY
A GREAT PLACE TO BIKE!

Do you ride a bicycle in Los Angeles County? YOU can make a difference! Help make L.A. a safe and enjoyable place to ride by joining the Los Angeles County Bicycle Coalition. Whether you ride for fun, transportation or both, LACBC works for you! Support our vision of a "Linked LA," a county-wide network of safe routes for biking.

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MEMBERSHIP FORM

Your Name: First Last

Yes, I am interested in volunteering with the LACBC.

Please do not share my information.

Gift Recipient's Information: (* indicates required fields)

Name: *First *Last
*Address
Address 2
*City, *State
*Zip
Email
	(Optional, but necessary to receive LACBC newsletters)

Membership Type:	New Renewal

SINGLE PAYMENT MEMBERSHIP
DELUXE LEVEL: Includes LACBC T-shirt!
	Tandem (2-Year)	Best Deal - Only 86¢ a week!	-	$89
	Solo (1-Year)	Only a buck a week!	-	$52
STREAMLINED LEVEL:
	Tandem (2-Year)	Save more than $10 now!	-	$59
	Solo (1-Year)		-	$35
	Student/Low Income (1-Year)		-	$15
Add an extra contribution! Half Century - $50 Full Century - $100 Giro our Hero - $200 Tour de Force! - $500 Other Amount - $
MONTHLY CONTRIBUTION MEMBERSHIP
PREMIUM LEVEL: Includes 2 year LACBC membership and T-shirt!. Support LACBC on an affordable continuing basis by pledging 24 monthly payments. Additional household members 13 years and older just $1/mo. each (provide Info below).
	Basic	Membership + T-shirt	-	$5/mo.
	Silver	Membership + T-shirt + $5 donation	-	$10/mo.
	Gold	Membership + T-shirt + $10 donation	-	$15/mo.
	Platinum	Membership + T-shirt + $15 donation	-	$20/mo.
(The selected amount will be automatically charged monthly for 24 months)
SELECT T-SHIRT SIZE: Select a size... Small Medium Large Extra Large No T-shirt, please
ADD HOUSEHOLD MEMBERS:
Only $10 per person 13 years or older ($1/mo. per person if PREMIUM LEVEL membership)
Enter number of persons 13 years or older			-	$
Please provide their names (separate with commas)
Kids under 13: add to your membership for FREE!
Please provide their names (separate with commas)
LET US KNOW HOW YOU FOUND OUT ABOUT LACBC:
Select how... Friend Family LACBC Web Site Other Web Site Radio Television Blog Event Other
Please describe (name, web address, etc.)
Please allow 6 to 8 weeks to receive your membership card and packet in the mail.

Print the MAIL-IN FORM (PDF) to pay by check.

Join us and receive these MEMBERSHIP BENEFITS:

• Membership Card - your ID for discounts
• Up to 20% off at participating bike shops
• Discounts on rides, workshops, and special events like the L.A. River Ride
• LA County bikeway map
• California Bicycling Street Smarts booklet
• Informative e-newsletter and updates
• LACBC T-shirt (with Deluxe membership)
• Knowing you're contributing to create a better, bike-able L.A. County

Los Angeles County Bicycle Coalition is a 501(c)3 nonprofit organization.

MAGNESIUM ($1,000+)

Attorney at Law

A bicycle accident lawyer concerned with all bike accidents and cycling injuries.

TITANIUM ($500+)

Ed Begley Jr.
Stuart Bombel
Eric Hamilton
Foundation Source
Cole Frates
Richard Hoffman
Los Angeles Wheelmen

www.lawheelmen.com

ALUMINUM ($250+)

STEEL ($150+)