Texas Motorcycle Rights Association
Membership Application
275 Old Lexington Rd.
Elgin, Texas 78621
PLEASE PRINT
Name / Names:_________________________________________________________________________
Address:_______________________________________________________________________________
City/State/Zip:____________________________________________Phone:
( )___________________
County:____________________________________________ Senate District # : ____________________
E-mail:_______________________________________________________________________________
Chapter: ______________________________________________________________________________
Membership Levels
( ) New - $25 for one year; receives (1) FREE sew-on patch. Renewal - $25 for one year
( ) Couple - $40 for one year, receives (2) FREE sew-on patch. Renewal - $40 for one year
( ) Individual Life - $300 for life, receives (1) FREE sew-on patch.
All levels of membership receive (1) Monthly copy of the Warrior.
Major Supporter Membership Levels
( ) Supporter - $100 ( ) Bronze - $250
( ) Silver - $500 ( ) Gold - $1000 ( )
Platinum - $1500
My check/money order for $_________ is enclosed. Do not send cash!
( ) Please charge my credit card for payment in full of
$_____________________. ( ) MasterCard
( ) Visa
No.________________________________________________________________Exp.______________
Signature:_________________________________________
Received membership patch: ( )Yes ( )No
Membership in Texas Motorcycle Rights Association.
Received from:________________________________________ the amount of ______________________
For: ( )New-one year, (
)Renewal-one year.( )Couple-one year,
( )Couple Renewal-one year. ( )
Life.
Signature:____________________________________________ (TRMA-2 Member)