The News
Membership Applicaton PDF Print E-mail
NEW MEMBER INFORMATION SHEET
Attention : Mareina Rautenbach Fax no 086 612 2932
Cell no 082 922 9778
Rider Information
Surname Name
Postal address
Tel no work Postal code
Fax no Tel no home
E-mail address Cell no
Date of birth Occupation
Harley Details
Model Colour
Year Reg no
Pillion Information
Surname Name
Tel no work Tel no home
Fax no Cell no
E-mail address Occupation
Date of birth
Partner Information
Surname Name
Tel no work Tel no home
Fax no Cell no
E-mail address Occupation
Date of birth
Harley Details
Model Colour
Year Reg no
Emergency Details - in case of accident
M/Aid - Self Number
M/Aid - Pillion Number
M/Aid - Partner Number
Allergies - Self Bloodgroup
Allergies - Pillion Bloodgroup
Allergies - Partner Bloodgroup
Contact person in case of emergency:
Self Tel no
Pillion Tel no
Partner Tel no
Who introduced you to Steelwings Name
Fees
Membership R 700 per person Membership R
No additional charges for name badges and colors
Total R
Date Signature