
You may print out this page to submit
your membership application to the VJEMC.
1 year membership=$15 _______
2 year membership=$28 _______
Note: All payments must be made in U.S. Funds
Same price for anyone from any country!!
Name: ________________________
Street: __________________________
City: ____________________________
State: ___________________________
Country: _________________________
Zip Code: _______________
Phone: __________________________
Email: ___________________________
I was referred for a VJEMC membership by _____________________________
Motorcycles in your collection or on your want list:
________________________________________________
________________________________________________
Would you be interested in being an VJEMC field representative in your area?
YES NO MAYBE
Mail completed form to:
VJEMC
4492B
Annabell
Circle
Green Bay, WI 54313
©2008 - VJEMC
All rights reserved.