Canadian Sidecar Owners' Club

Family Membership Application, Renewal and
Change of Information Form

Name ________________________________________ Membership # ___________

Address ______________________________________ City ___________________

Prov./State ______________________________ Postal/Zip Code ________________

Telephone area code( )________ - ________________

Spouse or Partner __________________________________________

Passengers' Names (& ages if children) ______________________________________

______________________________________________

Motorcycle - Year/Make/Model _____________________________________________

Sidecar - Year/Make/Model _______________________________________________

Internet Address ________________________________________________


Annual Membership Dues

(New Members Pay Full Amount)

Canadian Address New $ 40.00 Can. ______ Renewal $ 30.00 Can. _____

American Address New $ 40.00 U.S. ______ Renewal $ 30.00 U.S. _____

Overseas Address New $.45.00 U.S. ______ Renewal $ 35.00 U.S. _____

Mail cheque in appropriate funds, U.S. or Can., to THIS ADDRESS

Canadian Sidecar Owners' Club
c/o Carol Harper
6465 Line 6  
RR3 Harriston, Ontario
N0G 1Z0

For office use only
Date received _______________ Expiry date __________________

Amount received_____________ Cheque number _______________

Comments _____________________________________________________________________________

Rev. January 30, 2008