Membership Aplication


Name: ________________________________________________________________________

Address: ____________________________________________________________________

______________________________________________________________________________

Phone #: _______________________________Cell #:_____________________________

E-Mail: ______________________________________________________________________

Name of Fire Dept: _________________________________________________________

Emergency Contact
Name/Number: _____________________________________________________________

Are You Being Sponsored? Yes/No

If Yes By Whom: ___________________________________________________________

Make/Model of Bike: ______________________________________________________

Circle One:  Rider / Passenger

I the undersigned understand the rules and responsibilities of membership in Fire and Iron Motorcycle Club and pledge loyalty to the club and adhere to the rules and regulations with the best of my ability.

Print Name: _____________________________________________________________________

Sign Name: _________________________________________________Date: _______________
Complete form and return it with $75.00 new membership fee to:
Fire and Iron Station 17
8514 Pleasant Valley Ln.
Watertown, WI 53094


Office use only

    Date Joined: _______________ Number of sets of colors: _______