Red Knights M.C. PA,
Chapter 6 Levittown
Membership Application
NAME________________________________________ DATE__________________________
ADDRESS_____________________________________
PHONE__________________________
CITY & STATE_________________________________
ZIP_____________________________
DATE OF BIRTH_____/______/_______ Drivers License #_________________
MOTORCYCLE MAKE__________________________ MODEL__________________________
LICENSE PLATE #______________ Insurance
Carrier & Policy # _____________
MOTORCYCLE MAKE__________________________ MODEL__________________________
LICENSE PLATE #______________ Insurance
Carrier & Policy # _____________
FIRE SERVICE AFFILIATION_______________________________________________________
FIRE SERVICE ADDRESS__________________________________________________________
FIRE CHIEF ___________________ PHONE NUMBER_______________________
Membership
Applied for: (circle one) Active or Social
Do you have
someone who is sponsoring you for membership? If so please list their Name and Phone number below.
1._______________________________
2._______________________________
I, THE UNDERSIGNED, HEREBY APPLY FOR MEMBERSHIP IN THE RED KNIGHTS INTERNATIONAL FIREFIGHTERS MOTORCYCLE
CLUB, INC. PENNSYLVANIA CHAPTER VI. I AGREE
TO ABIDE BY THE CONSTITUTION, BY LAWS AND RULES AND REGULATIONS THAT GOVERN THE MEMBERSHIP.
APPLICANTS
SIGNATURE______________________________________DATE_________________________
APPLICATION
FEE:
NONE
ANNUAL DUES:
ACTIVE &
ASSOCIATE TWENTY
THREE DOLLARS ($23.00) SOCIAL DUES: FIFTEEN
DOLLARS ($15.00)
APPLICATION
FEE & DUES REQUIRED UPON REQUEST FOR MEMBERSHIP!!!
MAKE CHECK
PAYABLE TO: Red Knights Motorcycle Club PA, Chapter 6
MEMBERSHIP
COMMITTEE RECOMMENDS ACCEPT
REJECT
MEMBERSHIP
COMMITTEE SIGNATURES ____________________________________
____________________________________
