Membership Application

Got what it takes?

Why not apply?

Membership Application

          THIS AREA FOR CLUB USE ONLY

                                                           Sponsored by:______________________________________

                                                            Officers Recommendations: Yes_________ No_________

Vice President:     Yes__________ No__________      ________________________________________

   President:         Yes__________ No__________    ________________________________________

Membership Application

$10.00 application fee due at sign-up. This fee is refundable should an applicant not be accepted into the Club. Must be at least 21 years of age to apply!

APPLICANT INFORMATION
*Last Name:
*First Name:
*M.I.:
*Nick Name:
*Email:
*Street Address:
*City:
*State:
*Zip Code:	(5 digits)
*Home Phone:
*Cell Phone:
*Work Phone:
EMERGENCY CONTACT INFORMATION
Name:
Relationship:
Street Address:
City:
State:
Zip Code:	(5 digits)
Home Phone:
Cell Phone:
Work Phone:
MOTORCYCLE INFORMATION
Make:
Model:
Year:
Color:
Driver's License #:
M/C Endorsement	Yes No
License plate #:
Proof of insurance?	Yes No
Registration verified?	Yes No
Riding experience: (Years/Months)
Group riding experience?	Yes No
OATH
DISCLAIMER	The above information is true to the best of my knowledge. I fully understand and accept that membership may be denied or suspended at any time should any of the information I have given above prove to be false, or should I violate any of the By-laws of my Chapter. The decision of the President of the Chapter shall be binding. If applying for "Full Membership" I further attest that I have read and fully understand the following disclaimer: If approved for membership I will be in a probationary status for a period of six (6) months to one (1) year, during which time I will be observed and advised on principles and rules of the East Coast "Busas" Motorcycle Club. After successful completion of the probationary period, I will be voted in as a full member by a majority vote at a membership meeting. If at any time my sponsor or any officer feels that I am not in compliance with the principles and rules of the club, I must receive a majority vote at a membership meeting in order to remain a member of the club.

"Black Sweat" by Prince