SOUTH PENN ENDURO RIDERS MOTORCYCLE CLUB APPLICATION
NAME:______________________________________________________
ADDRESS:___________________________________________________
CITY:________________________________________________________
STATE:_________________________ZIP:_________________________
TELEPHONE NUMBERS
HOME:_________________________
WORK:____________________
EMERGENCY:______________________
FAX NUMBER:________________________________________________
E-MAIL:______________________________________________________
AMA NUMBER:_______________________________________________
ECEA NUMBER:______________________________________________
DATE OF BIRTH:______________________________________________
CLASS:______________________________________________________
BIKE:________________________________________________________
TYPES OF RIDING:____________________________________________
FAMILY:_____________________________________________________
PERSONAL INTERESTS:_______________________________________
SEND TO SPER
P.O. BOX 836, CARLISLE, PA. 17013
WITH NEW MEMBERSHIP FEE OF $25.00 & $10.00 RENEWAL
PAYABLE TO SPER