Application for Membership in the Empire Chapter A.M.C.A.

Any new membership will now be applied to the 2023 roster

Thank you for your support!

Please print your name and address. Include your spouse's name for family membership

** Please send a copy of your current National Membership Card and a self-addressed stamped envelope! **

Name: ______________________________________________________________________

Spouse's Name: _____________________________________________________________

Your AMCA Number: ________________________________________________________

Street: _______________________________________________________________________

City: _________________________________________________________________________

Zip Code: ____________________________________________________________________

Email Address: _______________________________________________________________

Phone Number: ______________________________________________________________

Dues $15.00 Per Year.

Make Checks Payable to "EMPIRE CHAPTER, A.M.C.A."Membership year is January 1 through December 31.

Spouse membership at no extra cost if you have a national family Membership.

Note: We cannot process your Empire Chapter membership application without your National A.M.C.A number. It is a requirement of the National A.M.C.A to be a member in order to join a Chapter. Send

Application to:   

Karen Benson 10971 County Line Rd Forestville, NY 14062 (716) 934-3137 krnbenson5@gmail.com