Membership/Renewal  Application

Personal Information
Your Name:
Mailing Address
City
State:
Zipcode
Phone: (with area code)
Email Address
Dues are $15.00 per year.  Membership is January 1st Through December 31st.
This is a new Membership is  $15.00
(paypal or Check)
Lifetime  Membership is $250.00
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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