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Michigan Gold Wing Association
P.O. Box 237
St Clair Shores, Michigan 48080

Membership Application
MGWA, Inc. is a group of motorcycle enthusiasts who enjoy the close comraderie offered through the numerous social activities, riding tours and association gatherings. MGWA is a non-profit organization, registered and incorporated in the State of Michigan with a goal to promote a more favorable image of motorcyclists, participate in motorcycle safety and lend assistance to charitable organizations.
                                          Master (Goldwing/Valkyrie) Membership              Affiliate (non-Goldwing/Valkyrie) Membership
Master/Affiliate Member Information
  Name   Home Phone – –
  Address   Work Phone – –
  Address
  Birthday   / /     Years M/C driving   M/C endorsement Yes No
  CB Handle AMA# District 14 #
Associate or Sweethart Member Information
  Name   Home Phone – –
  Address   Work Phone – –
  Address
  Birthday   / /     Years M/C driving   M/C endorsement Yes No
  CB Handle AMA# District 14 #
Gold Wing Information
  Year Model Color
  Frame Serial # Engine Serial # 

I certify that the above information is correct ____________________________ 

                                           Date ____________________________

Master Membership $30.00
Associate Member $ 5.00
Initiation Fee $10.00
Affiliate $23.00
Affiliate-Associate $ 4.00
An initiation fee is required of all new applicants requesting a Master Membership. This fee covers the cost of an MGWA patch, pin, decal and flag. An initiation fee is NOT required for Associate Members, Affiliates or annual renewal of a Master Membership. Annual dues (renewals) are payable from January 1 to February 1 to maintain "good standing" or until March 1 to bring dues up to date.
Dues must be enclosed with this application.
Make checks payable to Michigan Gold Wing Association, Inc.

Rev. dt. 11/2004