PAMMC Application Form

Patriots Australia MMC

Membership Application Form
Chapter
WE HAVE ZERO TOLERANCE TO THE USE OF RECREATIONAL DRUGS WITHIN OUR CLUB

Membership:
Applicants that currently Serve or have Served in the ADF, or with any Regular / Reserve or Allied Defence Force can apply for Full Member status in Patriots Australia MMC (PAMMC):
NOTE:
• A Chapter cannot exceed the ratio of 3 Members to 1 with Current Associate Members,
• Not all Chapters accept an Associate type of Membership,
• No more Associates Members will be accepted as from 18th March 2018.
Civilians that have not served in the ADF, or with any Regular / Reserve or Allied Defence Force, but wish to become a Riding Supporter of a PA MMC Chapter, may apply for Riding Supporter status within a PA MMC Chapter, that offer that form of Membership. Riding Supporter:
NOTE:
Not all Chapters offer this type of Membership,

• Riding Supporters are not transferable between Chapters unless a Partner or Sibling of a Member,
• Application for Riding Supporter status, does not have to be forwarded to Administration as a Riding Supporter is managed at Chapter level only.
Non Riding Supporter status is open to any Partner or Dependent of a Full Member or person who has not Served with any Regular or Reserve Force.
All Riding & Non Riding Supporters must:
• Agree to abide by the National Constitution & all By‐Laws of the Club & Chapters,
• If requested, leave any Meeting (eg. NAGM, State, Chapter or other Club) being conducted by the Members of their Chapter.

I Wish to Apply for Membership
Given Names*
Surname*
Ride Name to be issued by Chapter:
Address:
City/Town:
State:
Post Code
Home Phone
Mobile Phone
Email*
example@example.com
Date of Birth

DayMonthYear
Date of Application

DayMonthYear
Official Number:*
PMKeys:
Miltary Service*

NavyArmyAirforceAllied (DF)
Overseas Service:
Medal / Awards / Citations / Commendations:
PATRIOTS AUSTRALIA MMC
Are you or have you ever been a Member of any other Motorcycle Club:*

YesNo
If YES, which one?
Driver's Licence No:
State Issued:
Class:
Applicants for Member,or Rider Supporter must have a Motor Cycle of 250cc or greater in road‐worthy condition and must have minimum of 3rd Party Insurance.
Make of motorcycle:
Model:
Capacity:
I am aware that this Application is subject to the conditions details in the Club Constitution and By‐Laws. I agree that all information provided is truthful and accurate .
I agree to follow all Club and Chapter Constitutions and By‐Laws.
I acknowledge that no Public Liability or Insurances are included in my membership and agree that I will not hold the Club liable for any loss or injuries suffered by me or my guests on any Club activities.

PRIVACY STATEMENT

Any information given to the Club will be held by the National Secretary and will only be used for Club purposes e.g. clarification of Military Service, Club Members Contact List & for the collection of Annual Fees. No information will be passed onto any 3rd party unless express permission is given by the Nominee/Member or Supporter in writing to the Chapter Secretaries.

Lodgement of this Form will indicate your acceptance of the Club Constitution, ByLaws and Rules.
Next Of Kin /ICE
Contact Phone Number
Signed:
Witness:
Date

MonthDayYear
Date
Fee's Due:
BSB
Acc No:
Acc Name:
Chapter use only:(IMPORTANT TO BE FILLED IN BEFORE SUBMISSION TO ADMIN)
Fee's paid:$
Receipt #:
Date

MonthDayYear
Date
Class of Licence Witnessed

YesNo
If Yes which one/s:
Should be Empty:

Patriots Australia MMC

PATRIOTS AUSTRALIA MMC