Associate Member (Not Retired) Membership Application

Associate Member (Not Retired) Membership Fee: $12.00

Please fill out and submit the form below. Although it is not required to provide a phone number, if you choose to include a phone number with your application please submit your phone number without dashes, spaces or parenthesis (9999999999 format). You will be redirected to PayPal for dues payment upon submission. If you are not redirected to PayPal or experience an error message from PayPal, please use Google Chrome or Firefox web browser to complete the form. If you require further assistance, please contact the state office at 225-927-8837 or 

Associate Member (Not Retired) Membership Application
Street Address
Address Line 2
State / Province / Region
Postal / Zip Code
How would you like to receive the LRTA Newsletter? (Select one) *
Please check here if you were referred by an AMBA Agent or received information from AMBA to join LRTA.

Once you click submit, you will be redirected to PayPal to complete your payment information. If you have any problems, or questions, please call LRTA at 1-888-531-1992 or (225) 927-8837 during normal business hours.