Member Information Form

MEMBERS INFORMATION FORM
Capital City Wings
Chapter CA-C Region F, District CA

Please provide the following information:

Member New Update

First Name

Last Name

Middle Initial

Nickname

Sex Male Female

Street Address

City

State/Province

Zip Code

E-mail

Work Phone

Occupation

Home Phone

Cell Phone

Birthday
(Month and Day Only)

Type of Motorcycle

GWRRA Number

SPOUSE

First Name

Last Name

Middle Initial

Nickname

Spouse if different

Street Address

City

State/Province

Zip Code

E-mail

Work Phone

Occupation

Home Phone

Cell Phone

Birthday
(Month and Day Only)

Type of Motorcycle

GWRRA Number

Anniversary

Children Names

Comments

This information is for chapter CA-C officer and staff members, used to notify them of upcoming rides, meetings and other chapter functions.
If you are not a member and would like to join us also please fill out this form.
Copyright © 2004 [Capital City Wings]. All rights reserved.
Revised: 03/29/08

Submit Internet comments, suggestions and questions as follows:

Member	New Update

*First Name*
*Last Name*
*Middle Initial*
Nickname
*Sex*	Male Female

Street Address
City
State/Province
Zip Code
E-mail
Work Phone
Occupation
Home Phone
Cell Phone
Birthday	(Month and Day Only)
Type of Motorcycle
GWRRA Number

*SPOUSE*
*First Name*
*Last Name*
*Middle Initial*
Nickname
	Spouse if different
*Street Address*
*City*
*State/Province*
*Zip Code*
*E-mail*
*Work Phone*
Occupation
*Home Phone*
*Cell Phone*
*Birthday*	(Month and Day Only)
Type of Motorcycle
GWRRA Number

Anniversary
Children Names

Comments