 |
| |
| Application for Membership |
| PLEASE PRINT LEGIBLY |
| NAME ____________________________________________________________ |
| ADDRESS _________________________________________ Apt.#___________ |
| CITY _____________________________________ STATE ______ ZIP _________ |
| HOME PHONE ________________________ CELL PHONE __________________ |
| EMAIL _____________________________________________________________ |
| __ Address Change |
|
EMERGENCY INFORMATION: |
| CONTACT _________________________________ PHONE _________________ |
| DATE OF BIRTH ___________________________ GENDER __ Male __ Female |
| |
I am interested in volunteering for:
|
| __Day Rides |
__Three Flags Classic |
__Board Positions |
__Other ________________ |
| |
One Year |
Two Year |
| New Member |
__$25 |
__$45 |
| Renewal |
__ $25 |
__ $45 |
| Renewing Life Member |
__ Free |
Existing Membership # _____________________________________ Expires _______
Club Name ___________________________________________________ __ Outrider
|
In making this application for membership, I hereby agree to comply with the rules
governing the Southern California Motorcycling Association while holding membership.
SIGNATURE _____________________________________________
Date __________________
|
For Office Use
|
| S.C.M.A #______________ Expires________________ |
Revised 01/01/12
|
If you have any questions, please send an email to sallyjbishop65@gmail.com or call Sally Bishop 714.693.7801 |
Mail w/ check to:
SCMA
PO Box 487
Norwalk, CA
90651-0487
|
Please allow sufficient time before the start of the 3 Flags Classic and/or your USA 4 Corners Tour to allow processing and return mail. |
Membership
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