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ESPA Membership Application Form

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EMPIRE STATE PASSENGERS ASSOCIATION

MEMBERSHIP FORM

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         I Want to join ESPA to improve passsenger service and add my voice to 
YES      transportation planning in New York State.  Dues include subscription 
         to the state association publication, ESPA Express.  (Dues are not tax 
         deductible.)
          _                        _                      _
Enclose: |_| $10.00 Introductory  |_| $30.00 Family      |_| $75.00 Patron
         |_| $24.00 Renewal       |_| $50.00 Sustaining  |_|$100.00 Corporate
         |_| $12.50 Renewal (Student, Senior)            |_|$300.00 Life         
         |_| $___________  other

NAME __________________________________________________________________________

ADDRESS _______________________________________________________________________

___________________________ ZIP ____________     TELEPHONE HOME _______________

My Representative in Congress ___________________________  WORK _______________
 _            _
|_| Renewal  |_| New                   Mail to: ESPA
                                       PO Box 434
                                       Syracuse, New York 13209
 _  
|_| Please send me information on N.A.R.P., the National Association of
    Railroad Passengers, to which many ESPA members belong.