West Bank Motorcycle Club
     Membership Application

Please Print
Name: __________________________________

Address1: ________________________________

Address2: ________________________________

City: ___________________________________

State: ____________________ Zip: __________

Home Phone: _______________________________

Cell Phone: ________________________________

eMail: ___________________________________

Web Site: _________________________________

Insured by: ________________________________

Bike Make: ______________ Model: _____________

Paid to: ________________ Date: _____________

Dues: $ ____  Member: __  Sponsor: __  Other: __________

  - - - - - - - - - - - - -    fold here and tear off bottom portion   - - - - - - - - - - - -

Receipt for dues paid to West Bank Motorcycle Club

Paid to: _________________________________________

Date: _________________________  Amount: _________
~hn2010.03.24

 Stop at Whiskey Junction on rides days (Wednesday and Saturday - see the Rides Schedule)

 Ask any of the riders present to identify the West Bank Motorcycle Club Treasurer or any
  of the club officers. They will be happy to take your application and provide answers to
  any questions you may have.  
 WBMC dues is $20 per year for members.     Sponsorships:  $30, $50 or $100 per year