SMC MEMBERSHIP APPLICATION
* Required
Email address
*
Your email
APPLICANT INFORMATION
Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Driver's License
*
Your answer
State
*
Your answer
D/L Expiry Date
*
MM
/
DD
/
YYYY
Mobile
*
Your answer
Other Phone Number (Home/Office)
Your answer
Current Home Address
*
Your answer
City
*
Your answer
State
*
Your answer
Postal Code
Your answer
Email
*
Your answer
Motorcycle Endorsement
YES
NO
Clear selection
Motorcycle Year
Your answer
Motorcycle Make
Your answer
Motorcycle Model
Your answer
Insurance Company
Your answer
Policy Number
Your answer
EMERGENCY CONTACT
Name
*
Your answer
Relationship
Your answer
Phone
*
Your answer
Email
Your answer
Address
Your answer
City
Your answer
State
Your answer
Postal Code
Your answer
General Vows/ Commitment to Sikh Motorcycle Club, (a California Non-Profit)
1. Do you authorize SMC to share and publish your Photographs, Audio and Video, in our newsletter, website, social media, televised publications and/or directory?
*
Yes
No
2. Do you agree to abide by the Rules and Regulations of the Sikh Motorcycle Club?
*
Yes
No
3. Do you agree to abide by the Policies and Procedures of the Sikh Motorcycle Club?
*
Yes
No
4. Do you agree to support the Mission and Vision of the Sikh Motorcycle Club?
*
Yes
No
Your Interests and/or Skills (check your choices)
Local Rides
Annual Ride
Community Outreach
Dastaar (Turban) Tying
Video/Photography
Event Organizer
Communications/Media Person
Fundraiser Events
Poker Runs
Social Media
Other:
MEMBERSHIP LEVEL
You will receive a separate email for membership fee payment arrangements or a membership coordinator will contact you.
(Choose 1)
*
Associate Member: $50
Club Member: $200 *One time Initiation Fees and **$100 Annual Renewal
Required
*One Time Initiation Fees of $200: For Club Members only: includes club patch which is the SOLE property of the Sikh Motorcycle Club. **Annual Renewal Fees: $100 over age 25 and $35 for Student Members. *Initial below to acknowledge the terms of the Full Membership _______
*
Your answer
AUTHORIZATION
I authorize Sikh Motorcycle Club to conduct a safety check at any time during my membership with the club. I understand that none of the trips or other activities organized by the Sikh Motorcycle Club is covered by any insurance. The club has no responsibility for the craft or its driver. I authorize the verification of the information provided on this form by the administration of Sikh Motorcycle Club.
*
YES, I AGREE
Required
NAME OF APPLICANT (SIGN)
Your answer
DATE OF APPLICATION
*
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
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