RED
NIGHTS
INTERNATIONAL MOTORCYCLE CLUB
NEW YORK CHAPTER # 8
APPLICATION FOR MEMBERSHIP
DATE OF THIS
APPLICATION:___________________
NAME:________________________________________________________________
ADDRESS:_____________________________________________________________
CITY:___________________________STATE:__________________ZIP__________
PHONE(HOME)_____________________________(CELL)____________________________(WORK)_________________
MOTORCYCLE
YEAR__________MAKE_______________________MODEL___________________
YEARS
RIDING_________________ AMA MEMBER #_______________________
FIRE DEPARTMENT AFFILIATION
FIRE
DEPT_____________________________________________________________
MEMBER STATUS
ACTIVE______CAREER______LIFE______ASSOC______
VERIFICATION(CHIEF OR OFFCER IN CHARGE)
NAME________________________________________________________
PLEASE
ENCLOSE WITH YOUR APPLICATION A MONEY ORDER OR CASH IN
THE AMOUNT OF $25.00 ($15.00 APPLICATION FEE
& $10.00 ANNUAL DUES)
MADE PAYABLE
TO ‘LYLE SCALZO’ AND MAIL TO
LYLE SCALZO
RKMC/NY#8
THANK YOU FOR YOUR INTEREST AND SAFE RIDING!