Membership  Application

Personal Information
Your Name:
Mailing Address
City
State:
Zipcode
Phone: (with area code)
Email Address
Dues are $25.00 per year for Individual  and  $30.00 per year for Family
  Membership is January 1st Through December 31st.
This is an Individual  Membership for  $25.00
 		(paypal or Check)

 This is a Family Membership for  $30.00
 (paypal or Check)


Lifetime  Membership is $400.00
To  become a Lifetime member  you will need to send in this application.
The application  will go before the Executive Board  for a vote.
I would like to become a Lifetime Member.
Motorcycle Riders Association Mailing Address
Motorcycle Riders Association
PO Box 1471
Medford, Ore.
                     97530









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