UNITED MOTORCYCLE CLUB INTERNATIONAL

application form

Name:

Spouse:

Address:

City:State/Province:

Zip/Postal Code:Country:

Are 40 years of age or over?YesSpouse: Yes

Phone:e-mail:

I have read the Constitution and Bylaws and accept them as written.

Signature:

Spouse:

Membership card will be mailed to applicant. If you are in a State or Province with a Club,

your membership card will be mailed by that Club.

Print this form and mail to:

 US Address

1920 0 Street

Eureka, CA

95501-3027

 Canadina Address

UMCI

103-609 Truswell Rd

Kelowna, BC

V1W3Z1