RED KNIGHTS CHAPTER VT-1

APPLICATION FORM

Please fill in the information below and return the application to your Red Knights VT1 sponsoring
member. The application will be reviewed and processed by our membership. You will be notified of the
results in a timely manner.

Full Name: ___________________________________________________

Address: _____________________________________________________

Email: _______________________________________________________

Daytime Phone: _____________________ Evening Phone: _______________________

Birth Date: ____________________ (mm/dd/yy)

Current Fire Department Affiliation: _________________________________________

Total Years of Service: ________________

VT #1 Sponsor: ____________________________________________

Please answer the following questions: it will help our members to get to know you better.

1) Do you own your own bike? Yes / No

2) Do you currently have a valid motorcycle endorsement? Yes / No

3) Do you currently drive/ride a motorcycle? Yes/No Number of Year’s experience: _________

What’s your level of driving /riding experience: (please circle one)

Iron butt Live to Ride Weekender Average Beginner

4) Have you ever been convicted of a Felony: Yes / No

5) Do you object to being investigated? Yes / No

I, the undersigned, do hereby apply for membership to the Red Knights Motorcycle Club, Vermont
Chapter #1. I agree that I must abide by the Constitution and By-Laws of the Club.
Signature of Applicant:
_____________________________________________________________
Date Submitted: ________________________

Membership dues $25 (please remit with application) Pd ________ Rec’d _____/_____/_____.
(Makes checks payable to RKMC VT 1) Active / Social / Associate / Junior Member
If you are interested in purchasing Patches please enclose:
$40 for set of Back Patches (10” top rocker, Maltese cross, bottom rocker)

Paid: Yes / No Date Issued: ___________

$10 for Front Patches (4” top rocker, Maltese cross, bottom rocker)

Paid: Yes / No Date Issued: ____________

Please provide 2 Emergency contact names and phone numbers

Contact #1: ________________________________________ Home# __________________________

Cell #__________________________________

Contact #2: ________________________________________Home#___________________________

Cell #___________________________________

Thank you,

Executive Board Members

President: Tricia Stevens

Vice President: Todd Fischer
Treasure: Roy Spiller
Secretary: Heather Roberts
Quarter Master: Brad Fischer
Road Captains: Todd Fischer & Roy Spiller