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VJMC Membership Application


 

Dues: USA :…………………... $ 30.00/ One yr, $55.00 Two yrs, $80.00 Three yrs.

 

CANADA :………………………$ 30.00 CAD per year (or $ 30.00 US Dollars)

 

For all other countries:……… $ 50.00 US per year (includes airmail postage)

   
 

Your yearly membership entitles you to receive 6 issues of our bi-monthly magazines. These magazines are published for the periods Dec. Jan., Feb March, April May, June July, Aug Sept, & Oct Nov.

 

Checks to be made out to: VJMC
 

The following information will be used for our Club database and Magazine mailings!

 
 

PLEASE CIRCLE CORRECT APPLICATION TYPE ........ NEW ........RENEWAL

 

Member #_____________(if this is a renewal)

  FIRST NAME:_______________________________ LAST NAME: ____________________________________
 

ADDRESS: _______________________________________________________________________________

 

CITY : _________________________________ STATE / PROVINCE :________
  ZIP/POSTAL CODE: _____________________________ COUNTRY: _________________________________
 

PHONE: _____________________________E- MAIL : ___________________________________________

 
 

1) Please indicate your interests for the roster listing (max. 24 characters per line):

 
  Preferred manufacturer/s: ______________________ Preferred model:_______________
 
 

2) NEW MEMBERS; Please indicate how you learned about the Vintage Japanese Motorcycle Club of North America, Inc. (Check ONE of the choices below)

 
  ___ talked to a VJMC member; if so, please enter their name____________________________________
  ___

talked to a VJMC field rep: (name)______________________________________________________
  ___

saw the VJMC web site

  ___ saw VJMC at an event___(which one?)__________________________________________________
  ___

saw a copy of the VJMC magazine

  ___

saw other printed VJMC advertising

 
 

Mail completed application and dues to:

   
  Bill Granade , Membership Director ............................................................................. Phone: 813-961-3737
 

13309 Moran Dr . ..............................................................................................................Email: vjmcna@verizon.net
  Tampa , FL 33618-3011
   
  Thanks for joining our excellent club. We’re sure you will enjoy being a member.