MEMBERSHIP
Association for Injured Motorcyclists
Membership Application/Renewal
Name:________________________________________________________
Address_______________________________________________________
Phone______________________email: ________________________________________________________
New Membership ___________ or Renewal of Membership #____________________________
If new membership, how did you hear about
A.I.M.________________________________________________
Do you wish to be put on the volunteer list for any of the following?
- Hospital Visitation _________
- Bike Storage &/or pickup _________
- Helping out at events____________
Print this form and send with Membership fee $20.00 per person OR $30.00 per couple to :
A.I.M. Vancouver Island,
PO Box 998, Stn A,
Nanaimo, BC
V9R 5N2
Total Enclosed $______________