Membership Application - Knights on Bikes

Name(Required)

First Middle Initial Last

Spouse Name (Optional)

Address(Required)

Street Address City State ZIP Code

Home Phone #

Cell Phone #(Required)

Email(Required)

Diocese Name(Required)

Parish Name(Required)

KofC Council Number(Required)

Current Grand Knight(Required)

Are you a 4th degree member?(Required)

Yes

Assembly #(Required)

Do you own a motorcycle?(Required)

Yes

Do you have an endorsement?(Required)

Yes

Are you in good standing with your parish and council?(Required)

Yes

Signature(Required)

Date