2008 Member Application Form

Instructions: Please fill this form out by typing or selecting the appropriate information. Remittance information is at the bottom of the form.

First Name
 Last Name (Surname)
Address
City
State/Province
 Zip/Postal Code
Home Phone
 Work Phone (optional)
FAX (optional)
Country
 Email Address (optional)
2008 Dues @ USD $15/CDN $18
  
2008 AJSMOC calendar @ USD $11/CDN $13
 2006 Members Handbook (last years)@ USD $7/CDN$9
Matchless News back issues (complete set only) @ USD $10/CDN $13

please circle year(s) you desire back issues for (1999, 2000, 2001, 2002, 2003, 2004, 2005, 2007)
 
Total Enclosed (Check payable to "AJSMOC")

AJS, Matchless, & Norton Hybrid Motorcycles Owned (optional) - Please note that the data which you enter on this form will be added to our North American Machine Register unless you specifically request otherwise by checking the appropriate box below. Note: If your frame number begins with a zero, you have the frame casting number, not the actual frame number. 1946 and later frames numbers start with an A, C, or a number from 1 to 9. Check the steering head area or right side beneath the seat to find the correct number.

Please check if you DO NOT want the motorcycles listed below to appear in the North American Machine Register

Please check box if you DO NOT want your name, address and phone # listed in the next Member Handbook

  Bike #1 Bike #2 Bike #3
Year      
Make
Model      
Engine #      
Frame #      
Transmission Number      
Transmission type
Original Transmission?
Help (see below)

Help Codes:

  1. I am willing and able to help members with technical advice on this model
  2. I have some parts for sale or trade for this model
  3. I can furnish photographs or copies of literature for this model
Member's Signature
(All renewing and prospective members MUST validate this application with their signature)
 

Please returned completed form with payment to:
John Diederich, 118 Pointe Harbour Lane, Mooresville, NC 28117-3511

http://www.ajsmoc.com/memappl.html