Eastern Arizona  Motorcycle Riders
Membership Application
Annual Membership Fee  $10.00 Per Year
Please Print Clearly
Date:  __________
(1) Member's Name: _________________________________________

(1) Birthday (Day & Month Only) ________________________________

(2) Member's Name: _________________________________________

(2) Birthday (Day & Month Only) ________________________________
Phone:
1 (Home) ___________(Work) ___________
2 (Home) ___________(Work)____________
By  signing below:
I  affirm that I have read and understand:
The Eastern Arizona  Motorcycle Riders
By-Laws, and that I agree to abide by the by-laws for the duration of my  membership.
Signature
Signature
Eastern Arizona Motorcycle Riders (E.A.M.R.)
P.O. BOX 1135
SAFFORD, AZ 85548
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