<p> FMC New Member Application</p><p>NAME______</p><p>HOME ADDRESS______</p><p>CITY, STATE, ZIP______</p><p>HOME PHONE #______</p><p>WORK PHONE #______</p><p>MOBILE PHONE #______E-MAIL ADDRESS</p><p>Optional: Motorcycle: Years riding experience: Safety Courses passed:</p><p>Riding Level: ____BEGINNER ____INTERMEDIATE ____ADVANCED </p><p>Member Status (for FERA-IRS Purposes only) Please Check one.... I am a: ___Ford Employee, ___ Contract Employee,___A-Plan Eligible, _____Other</p><p>Ford Employees Only:</p><p>InterCo Address______Email ID______</p><p>Office Use Only: Dues Paid______Patch Picked Up?______</p><p>Please send completed form, together with a check for $20 annual dues, payable to Ford Motorcycle Club, via snail-mail to: Ford Motorcycle Club c/o Andrew Swift, 18400 Ryanwood Dr., Riverview, MI. 48193. Annual dues are $20, payable to "Ford Motorcycle Club". Please do not send cash. Rev. 4/11/2017</p>