NMA Club Charter Application The NMA is dedicated to the sport of off-road motorcycling

Charter Year *: _________________

* Club charter applications are due to the NMA by September 30th for the following charter year. Charters are good through December 31st of the chartered year.

Club Information (please print clearly)

Club Name: _____________________________________________________

Address: ________________________________________________________

City: _______________________________  State: __________  Zip: _____________

Officers

President:	___________________________	Address:	________________________________
Phone:	___________________________		________________________________
E-mail:	___________________________		________________________________

Secretary:	___________________________	Address:	________________________________
Phone:	___________________________		________________________________
E-mail:	___________________________		________________________________

NMA Rep:	___________________________	Address:	________________________________
Phone:	___________________________		________________________________
E-mail:	___________________________		________________________________

Does your club have an AMA charter? _______  If so, list charter # ____________________

Be sure to:

Complete all the information above. Enclose a complete club roster with your application. Enclose a check for the charter fee of $100.00. Send the application, roster and check to: NMA Club Charter Application 12016 231st Ave. E Bonney Lake, WA 98391

Thank you very much for supporting the NMA and the sport of off-road motorcycling!