MJM MEMBERSHIP

MJM MEMBERSHIP

Please print form and mail to:

Motorcyclists for Jesus Ministries;
693 West Westbrook Rd.
Brookville, Ohio 45309

Annual Dues: $15.00 [US] Single - $25.00 [US] Couple
$35.00 [US] outside the United States for single
and $45.00 [US] per couple per year

Lifetime Membership: $200.00 [US] Single
$300.00 [US] Couple

Please Print

Name_________________________________________

DOB____________ I’m a born again Christian [ ]

Spouse___________________________________________

(Constitutes one Woman legally Married to one Man)

DOB____________ I’m a born again Christian [ ]

Anniversary Date________________

Address_______________________________

City______________________________

State________________ Zip____________

Phone # ( ) ____________________________

Fax # ( )_______________________________________

E-Mail _________________________________________

MJM TEAM ___________________ _______________________________

M/C Club Affiliation ___________________________________________________________________

Applicants Signature Date

___________________________________________________________________

Spouse Signature Date

___________________________________________________________________

(Constitutes one Woman legally Married to one Man)

A note from the Board of Directors:

The Educational Guide can be viewed from the link below.

You will also receive a copy in your New Member Packet.

Prior to obtaining an MJM back patch you MUST read and acknowledge reading our
[click below for the link]
Educational Guide for Interaction with secular motorcycle clubs.