Application/Renewal for Membership
and
Name Tag Order Form
BMW Riders of Western Colorado, MOA #270 RA #319
Name(s):_________________________________________________________
Mailing Address:___________________________________________________
City, State, Zip Code:________________________________________________
Telephone Number:__________________________________________________
Email Address:______________________________________________________
Motorcycles:_______________________________________________________
MOA/RA Number:______________________________________________________
Other Associate members in family:______________________________________
Dues are $15.00 annually payable in January of each year.
Make check payable to BMW Riders of Western Colorado.
Club Nametags!!
Member Nametags are available to Club Members for $5.00. Please complete this form and include payment for pins desired and “options” with your renewal. Nametags will include the club logo and the member’s name and office if an officer.
Name on Pin:________________________________ Title:_______________________
Add $1 for Clutch Back (double stronger pin)
Add $2 for Magnetic Back
Name on Associates Pin:___________________________________
Add $1 for Clutch Back (double stronger pin)
Add $2 for Magnetic Back
Total included $15 renewal + $5 for each Pin + Options= ________________________
Thank You! Please complete and return soon. I am assuming if you do not return your dues, you do not want to remain on our mailing list.
Return to BMW Riders of
Western Colorado, P.O. Box 3271, Grand Junction, Colorado 81502
BMW Riders of
_________________________________________________________________________________