Washington State Knights of Columbus Knights on Bikes Membership Application Name(Required) First Middle Initial Last Spouse Name (Optional) Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific 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 No Assembly #(Required) Do you own a street motorcycle?(Required) Yes No Do you have an endorsement?(Required) Yes No Do you have insurance?(Required) Yes No Are you in good standing with your parish and council?(Required) Yes No Signature(Required)Date
