RED KNIGHTS

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

175 MAPLE STREET

CROTON N.Y. 10520

THANK YOU FOR YOUR INTEREST AND SAFE RIDING!