Membership Form

Please fill out the form below. Fields marked * are required.

Are you a New or Returning Member?*

New

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Membership Fee*

Lifetime for $500

5 years for $59.95 ($11.99/yr - Save 25%)

3 years for $42 ($14/yr - Save 12%)

1 year for $16

First Name*

Middle Name

Last Name*

Phone*

Texts

Email*

Residential Address

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Residential Street Address *

Residential Street Address 2

City*

State*

Zip/Postal Code*

County

Country*

Mailing Address

Mailing address is the same as above

Mailing Street Address*

Mailing Street Address 2

City*

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Zip/Postal Code*

Country*

Date of Birth

Alt. Phone

Add an alternate phone number to receive calls and texts. Standard message and data rates apply.

Enrollment includes membership for both you and your spouse, if applicable.
This is not required to become a member.

First Name*

Middle Name

Last Name*

Date of Birth

Phone

Alt. Phone

Are you a small business owner?*

Yes

Type of Business

How did you hear about AMAC?*

Payment Information

Card Number*

Card Holder Name*

Exp. Date*

Billing Zip Code*

Auto Renewal

Auto Renew My Membership

With auto-renewal you will:

Never miss an issue of your AMAC Advantage magazine.
Always receive the lowest renewal price then available to AMAC Members for your subscription term.
Avoid multiple renewal mail and email notices.

We'll automatically renew your subscription at the lowest renewal price available to
AMAC Members. You can cancel at any time by calling AMAC Member Services.

You can choose to turn auto-renewal off by unchecking the box above.

Make an additional contribution to the AMAC Foundation

Tax deductible contributions to the AMAC Foundation support our programs to inform and educate people on pressing issues such as Obamacare, Medicare, and Social Security. Contributions are processed with your membership fee transaction and you will see one charge on your credit card statement. Once accepted by the Foundation, all donations are non-refundable.

Additional amount you wish to contribute (optional)

Review Your Information

Your Membership

:	$
AMAC Foundation Contribution:	$
Total: $

Make Changes

From all of us at AMAC,
Welcome to the AMAC Family!

It is individuals like you who are saving the America we love!
We couldn’t do this without you!

We encourage you to do 3 things right now to get
the most out of your new membership!

Engage in the Fight!

Visit www.amacaction.org to see
how to get involved and continue
to make a difference.

Start Saving Money Today!

Visit www.amac.us/benefits to
see what cost savings benefits
you have immediate access to.

Stay Connected!

Download the AMAC App,
subscribe to the Better For America Podcast
and follow us on your favorite social media
site to stay up to date with the latest news

You will receive your AMAC Welcome Kit and Membership Cards in 4-6 Weeks.
Please call 1-888-262-2006 if you have questions.

We wish you an abundance of joy and good things to come in 2023.

Welcome to AMAC!

Your Order

Residential Address

Mailing Address

Contact Info

Order Information

:
Member ID:
Exp. Date
Order Number
Payment Date
Total Amount

Membership Card

John Q. Sample

Member ID
123456-7

Member Since
02/02/2015

Valid Through
02/02/2016

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