Idaho Vintage Motorcycle Club Application for New or Renewal of Membership

Please print or type legibly – we will use this information for our club roster (address will be omitted from roster for security reasons)

NAME________________________________________________________________________ ADDRESS____________________________________________________________________ CITY_____________________________________STATE__________________ZIP__________ TELEPHONE__________________________________ E-MAIL_______________________________________

Would you like your name/e-mail/photos added to the club website & Megaphone newsletter? (circle one)     Yes     No

YEAR(S) OF MOTORCYCLE(S) ________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________

MODIFICATIONS / NOTES  _________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________

Please make a $10.00 check or money order payable in U.S. funds to: Idaho Vintage Motorcycle Club

Mail to:

Idaho Vintage Motorcycle Club

11371 Hercules Dr. 

Star, Idaho 83669

U.S.A.