Application for Associate Membership
To the President, Officers and Members of the
Masonic Motorcycle Association of Australia Inc.

The following respectfully asks that they may be admitted as an Associate member of the Masonic Motorcycle Association of Australia Inc.

Questions to be answered by Applicant
All items in red are required

Full Name

Nickname

Address

City State Postcode

Phone Number (9999 - 9999)

Mobile Number

Email

Current Motorcycle Model

Fees: $50 Regalia Costs(1 time fee) plus $25 Annual Membership Fees or pro-rata

Total: $75

By submitting this form the applicant agrees that all the above information is correct and agrees to the membership fees.