Red Knights M.C. PA, Chapter 6 Levittown

Membership Application

Name___________________________________________________

Address_________________________________________________

City, State_______________________________________________

Zip code______________________________________

D.O.B_____/______/_______  Drivers License #________________

Motorcycle make__________________________________________ 

 Model____________________________________________________

License plate #____________________  State _________________

Insurance Carrier  ________________________________________

Fire Service Affiliation_____________________________________

Address__________________________________________________

Chief or President ________________________________________

Phone #_______________________

Membership Applied for: (circle one)   Active  Social    Associate

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 ChapterVI.  I agree to abide by the Constitution, By Laws, rules and regulations that govern the membership. 

APPLICANTS SIGNATURE______________________________________DATE__________

Annual Dues:                                

Active or Associate member dues: $23.00  

Social member dues: $23.00

Application fee and dues required upon request for membership.

MAKE CHECK PAYABLE TO:  Red Knights Intl. M.C. PA. 6

Membership committee reccomendations:

Accept                                Reject 

Membership committee signatures:

_____________________________________________

                                                                                               _____________________________________________