Date Of Application:____________
Badgers M/C
APPLICATION FOR MEMBERSHIP

To qualify for membership you must be a California Peace Officer or Fireman in good standing.  Retired Police Officers and Firemen are also eligible and welcome.  Upon acceptance, all of your immediate family becomes members, however, only you have the voting privileges.  New members are expected to purchase a club riding jersey and pay the dues for the current year.  Non Peace officers  may become members if sponsored by a Peace Officer or Fireman in good standings and will serve a 6 month probationary period prior to being voted on by the membership.

Name:
Last:                                      First:                                 Middle :                        AMA #_______

Present Address:                                                            City:                                                 Zip:________

Home Phone:                                                       Bus Phone:___________________________

Age:                Birth Date:                          Email Address:_________________________

Agency:                                                                 Area of Assignment:________________

Sponsoring Member:_______________________________________________________

Riding Experience:

List Family Members:                                                           Sex:           Age:
1. _____________________________________________________________________
2. _____________________________________________________________________
3. _____________________________________________________________________
4. _____________________________________________________________________
5. _____________________________________________________________________

Dues: $25.00
Make Checks Payable to:
      Badgers M/C
      P.O. Box 6550
      Pine Mountain, CA 93222
For Further Information Contact: Jay Wickers: 661 242 2712
                                                     (Contact Jay Wickers regarding jersey)

Badgers Web Site: http://www.badgersmc.org