I wish to apply for membership with the Seekers Motorcycle Club.  No Annual fee will be charged.  Membership patch will be $25.00 each.  Please complete this form along with $25.00 for patch and return it to any officer or mail completed form and check or money order to:  Seekers Motorcycle Club - Secretary - 4782 Road Ridge Tpke, Raven, VA  24639.

           Name:  _______________________________________________

          E-Mail (optional):  _______________________________________

          Address: ______________________________________________

                            ______________________________________________

          Phone #: ______________________________________________

          Type of Motorcycle:  ______________________________________

I give permission for the Seekers Motorcycle Club to have my e-mail address, mailing address and phone # for listing on the clubs private computer membership list , for mailing and contact purposes only and permisssion to publish photos on Seekers Websites:

          Signature:  ____________________________________________________   

          Date:  ________________________________________________________