Richmond Triumph Register Membership Renewal/Application
                                     (Print out this page, fill out and mail to address at bottom)

Name______________________________________________

Street______________________________________________

Phone ( ____)____________

City________________________________________________

State_______________ Zip__________________

E-mail Address______________________________________
Notify the web master to add me to the RTR e-mail distribution list

Triumphs owned:

Model_________________ Year________ Series__________ Comm #_________________

Model_________________ Year________ Series__________ Comm #_________________

Richmond Triumph Register Club Membership
$20 per year with Electronic Spokes (include e-mail address)
$30 per year with Mailed Paper Spokes
Make Check or Money order payable to RTR

NEW MEMBERSHIP                       RENEWAL

Return this completed application to:
Jim Scherer, RTR Treasurer
15618 Moss Light Place
Moseley, VA 23120