Roller Skating Association International
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RSM Membership Application

Please take the time to complete all information associated with your organization. Please note that the Shipping Address is where you have large packages hand delivered (CAN NOT be sent to a post office box), and Mailing Address is where you have small mail sent (can include a post office box). Each individual member listed must include phone and email information for database and membership login purposes.

Dues: $450 per year for membership. Additional category listings may be purchased for $145 per category. Due annually on January 1. Two contact names allowed per company.

Company Information

Name of Business *
Shipping Address (No P.O. Boxes) *
City *
State *
Zip Code *
Mailing Address *
City *
State *
Zip Code *
Public Phone *
Best Phone or Cell Phone *
Email (do not use role addresses such as [email protected], [email protected], etc.) *
Fax *
Website *
Main Contact Person 1 *
Title *
Personal Email *
Main Contact Person 2
Title
Personal Email

Description of Services

Describe your products and/or services in detail *

Please check ONE category you would like to be listed under.

Note: Additional category listings beyond the first are available for $145 per category.
  • Coin-Op Lockers
  • Computer Technology
  • Consulting & Rink Planning
  • Costumes
  • Distributors
  • Financing/Financial Planning
  • Floors/Materials & Installations
  • Insurance
  • Legal Services
  • Music
  • Novelty/Redemption Products
  • Party Supplies
  • Play Equipment & Laser Tag
  • Roller Sports
  • Roller Skate Manufacturers
  • Skating Apparel
  • Snack Bar Equipment & Supplies
  • Sound System & Lighting
  • Special Products & Services
  • Vending Machines & Games
  • Wheel/Bearing Manufacturers
  • Wristbands/Tickets/Tokens
Please note: There is a 4% processing fee for all credit card transactions.

Payment


Total Due Today: $450.00

Credit Card Type *
Credit Card Number *               
Name On Card
Security Code
Valid Through
Credit Card Address 1
Credit Card City
Credit Card State
Credit Card Zip
Credit Card Phone Number
Credit Card Email Address
Please click submit only one time.  The transaction may take several seconds.


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