MERIDIAN MOTORCYCLE ASSOCIATION MEMBERSHIP APPLICATION
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DATE:___________________________ |
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NAME: First:___________________ MI___________ Last:_________________________ |
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ADDRESS: _______________________________________________________________ |
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CITY: ________________________ STATE:______________ ZIP:____________ |
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PHONE #: Home: _________________________ Cell: ______________________ |
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DOB: __________________________________ ____MALE ____FEMALE |
| EMAIL ADDRESS:________________________________________________________ |
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PLACE OF EMPLOYMENT: ________________________________________________ |
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TYPE OF MEMBERSHIP: ____INDIVIDUAL ____FAMILY |
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IF FAMILY MEMBERSHIP LIST THE NAMES OF ALL FAMILY MEMBERS (** Remember only spouses, children, or stepchildren under the age of 21 are eligible.) |
| 1. ________________________________ | 2. ________________________________ |
| 3. ________________________________ | 4. ________________________________ |
| 5. ________________________________ | 6. ________________________________ |
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LIST ALL OF THE OFF-ROAD MOTORCYCLES / ATV's YOU WILL BE RIDING ON THE TRAILS |
| 1. ________________________________ | 2. ________________________________ |
| 3. ________________________________ | 4. ________________________________ |
| 5. ________________________________ | 6. ________________________________ |
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