This form tells me you want to add
your name  under the state list.

If you have heart for motorcycle group,
you may fill out this form.

Please type on this form first then print it.   Mail this form to Paul T. Stefurak, 6855 Astoria Drive, Riverside, CA 92503-1005.

 First Name:   Last Name:   Nickname if any:

 Under what State, Province or (what country other than USA and Canada):

 Now, you pick which number below fits you best:

 1) From now on, if you want to keep your name on the Deaf Motorcycle list, you must pay only  $1.00 per year.  Also, if you make your own personal motorcycle webpage to be hyperlinked from the  Deafmotorcyclelinks page, it is free as long as you have paid $1.00 per year to keep your name on  the list.

 2) If you want to include your photos on the Deafmotorcyclelinks page, it will be limited to 2 photos  of each biker as long as you pay only $2.50 per year for photos and name on the list.  Again, it includes up to 2 photos and email address on the list.

iIf you don't have photo in jpg or gif format or don't know how, you may send me your Photo (limit two), and pay 5 dollars each for me to do the scanning and put it in the web page for you. If you want the photo(s) back, be sure to send me a self-addressed envelope with stamps. Thanks!

 Do you have your own webpage relating about biker? Yes      No
If yes, please type your correct URL name. SAMPLE: ( 
What is your url name?

E-mail address:
no fax allowed.
 If there is no email address, it will be discarded.

Did you type on this form first then print it?.  If so, please mail this form (printed paper)

Please make your payment to: Paul T. Stefurak,  6855 Astoria Drive, Riverside, CA 92503-1005.

Thank you!

Use the Browser Back Button to return to the previous page.