SCBAA - Membership, Class Online Application

Membership/Class Application

SCBAA - PO Box 3035 West Columbia, SC 29169 - 803-957-7577

PO Box 1894 - Lexington, SC 29071 803-957-7577

Please fill out our online membership and/or class form and we will process it as soon as possible. All fields and proper dates should be used! This form can be used for classes or general membership. Please contact our office to confirm any dates and status needed.
You can also download this PDF form, fill it out and mail it to our office by clicking here.
Note: This is not a Secured Page! If you feel uncomfortable passing your information online un-encrypted, please use our downloadable form as mentioned!

South Carolina Bail Agents Association
P.O. Box 1894
Lexington, South Carolina 29071
All info is kept Confidential!
* Required Items

Full Name *

Home (Mailing) Address *

Home City *

Home State (2 letter abbreviation) *

Home Zip-Code *

Organization, Employer or Company (if applies)

Business Mailing Address

Business City

Business State (2 letter abbreviation)

Business Zip-Code

Web Site (http://www.domain.com)

Home Phone (w/ Area Code) *

Cell Phone (w/Area Code)

Business Phone (w/ Area Code)

Business Fax (w/ Area Code)

Pager (w/ Area Code)

State License ID

Email *

Category (Check as many Boxes as applies only):
Bond Person ($75)Associate Member $100CE Class Registration ($125)
CE Class On Site/Late Registration ($150) Late Registrations is 5 Days prior to each class.

Location of Class Per Posted Schedule If Applies

Date(s) Per Posted Schedule If Applies

Additional Comments you feel may help the application process.

Full Name (By typing your name in the box below, you are agreeing that everything on this form is accurate and legal. It also signifies that you agree to dates and payments necessary to complete this application unless otherwise arranged. SCBAA reserves all rights to deny or accept any application for whatever reason they feel deemed.

* Required!!!

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