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RED KNIGHTS MOTORCYCLE CLUB

                                                                  CONNECTICUT CHAPTER II

17 Debbie Lane

Enfield CT. 06082

860-749-0222

E-Mail jgohagan@cox.net

Membership Application

Name ____________________________________________________Date ____________

Address___________________________________________________ Phone ___________

CITY________________________STATE______________________________Zip_______________

          E-MAIL_________________________________________________________

I certify that the above named individual is an active/retired member in good standing with the

Name of fire department_____________________________________________________at the present time.

Signature Chief of Service (Volunteer)_____________________________________________________

        OR OIC of Station (Paid)

I, the undersigned, do hereby apply for membership to the Red Knights Motorcycle Club, Connecticut Chapter II Inc .I agree that I must abide by the Constitution and By-Laws of the Chapter and I do have a valid motorcycle operators license and will maintain a valid motorcycle registration for any motorcycle I ride.

Motorcycle operators license no__________________________Applicants signature_______________________

Motorcycle; Make____________________ Year____________ Color __________________

Application Fee Two ( 2) dollars (non-refundable)

Annual dues; Seventeen(17) dollars (refundable, if not accepted for membership)

Application fee and annual dues collected:

RKMC Officer's signature_________________________________________________

After investigation of the above named individual, we, the membership committee

(recommend - reject) this applicant for membership.

Member Status _____________ Membership Committee ______ Member Number____________

Associate $12.00 Social $7.00 Membership Package_______

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