First Last MI. Ent.
ADDRESS ______________________________________________
______________________________________________
ZIP __________ CITY __________________ STATE _____
PHONE __________________ _____________________
Home Cell
___________________________________________________________________________________________
Do you have a moped? _______________________
Is your moped up to date? (license plate, ect.) _______________________
Are you legally allowed to drive a moped? _______________________
Where do you go to school? _______________________
Why do you want to join? _______________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Will you be able to attend the L.C.M.R. meetings? _______________________
___________________________________________________________________________________________
Thank You for applying, we will get back to you for your membership card.
Membership Fees: E-Mail: ________________________________
Monthly: $4
Yearly: $40
Fee's go toward websire, and the once a month newspaper.
Michael Sosebee
2809 Forest Hills Dr.
League City, TX 77573