Membership Application

Name:__________________________________________________ Age:____

Address:________________________________________________________

City:_____________________________________ State:____ Zip:__________

Phone#:_____________________Cell# (0ptional):________________________

E-Mail:____________________________________________*e-mail address is only shared
 with other club members

Other family applicants:

Name:____________________________________________________ Age:____

Name:____________________________________________________ Age:____

Name:____________________________________________________ Age:____

Name:____________________________________________________ Age:____

Name:____________________________________________________ Age:____

Are you an: 
(write in membership number)

AMA member__________________________ NMA member____________________

Skagit Motorcycle Club Membership Application
Today's date: ______________ Membership: New___; Renewal___ Membership type: Individual - $20___; Family - $40___
Member Information Name:__________________________________________________ Age:____ Address:________________________________________________________ City:_____________________________________ State:____ Zip:__________ Phone#:_____________________Cell# (0ptional):________________________ *E-Mail:____________________________________________e-mail address is only shared with other club members Other family applicants: Name:____________________________________________________ Age:____ Name:____________________________________________________ Age:____ Name:____________________________________________________ Age:____ Name:____________________________________________________ Age:____ Name:____________________________________________________ Age:____ Are you an: (write in membership number) AMA member__________________________ NMA member____________________ Please return to: Skagit M/C C/O Robyn Johnson 31413 English Grade Rd Stanwood, WA 98292**