NC BikePAC Application
Application for Membership
___ Copper Level $25.00
___ Silver Level $50.00 to $100.00
___ Gold Level $100 and over or monthly sustaining membership
Join and receive a vest pin just like the BikePAC logo!
If you would like to make a donation and not become a member, please note the donation amount here: ______________________
New Member __ Renewal __
PHONE (Not required)_____________________________
EMAIL (Not required)______________________________
Registered Voter? YES ? NO ?
Do you belong to a motorcyclists’ rights group (s)? If so, which one (s)?
Mail this completed form with your personal check to:
PO Box 1554
Shallotte, NC 28459
Membership is not tax deductible. 100% of the monies received are used for
lobbying, education and support of elected officials and candidates of North
Carolina who endorse the goals and objectives of NC BikePAC.