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Fill In application, print, and mail to:
BROTHERS OF THE THIRD WHEEL
HC 71 Box 183-5
Ava, MO 65608
USA
MEMBERSHIP APPLICATION

First Name
Last Name
NickName
Spouse's Name/NickName
Address
City
State
Zip Code
Country
Phone With Area Code
Cell Phone
Fax
Email
Type Of Trike (Engine)
New Or Renewal
Amount Submitted
Today's Date
Referred By
US and Canada Membership is $22.00 for single and $30.00 for couples. All overseas is $40. (USA Funds)