Click here to print this page. Please mail it, along with your first year's dues of $10.00, to:
      Bob & Joan Janick
      12212 N 700 W
      Silver Lake IN 46982

Please make checks payable to "The North American 40+ Touring Riders (NA40+TR)".

Date: ________________________________________________

Rider: _______________________________________________

Passenger: ___________________________________________

Address: _____________________________________________

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Phone: ______________________________________________

Birthday(s): __________________________________________

Anniversary: _________________________________________

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Motorcycle(s): _______________________________________

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