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Membership Application
Personal Information
First Name:
Middle/Initial:
Last Name:
Gender:
Female
Male
Non-Binary
Birth Date:
/
/
Home Address:
Address Line 2
City:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
American Samoa
Federated States of Micronesia
Guam
Marshall Islands
Northern Mariana Islands
Palau
Puerto Rico
U.S. Minor Outlying Islands
Virgin Islands
Armed Forces Americas
Armed Forces Europe, the Middle East, an
Armed Forces Pacific
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Northwest Territories
Nunavut Territory
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon Territory
Province (Foreign)
Zip Code:
-
Zip Suffix
Home Phone:
Email:
Emergency Contact
Name
Emergency Contact
e-mail
Emergency Contact
Phone 1 (xxx xxx-xxxx)
Emergency Contact
Phone 2 (xxx xxx-xxxx)
How did you hear about us?
(check all that apply)
Brochure in bike shop, etc.
Friend
Internet
Newsletter
Twin Cities Marathon Expo
St. Paul Classic
My Special Skills or Talents are:
(check all that apply)
Bicycle advocacy
Bicycle mechanics
Bicycle safety
Board membership
Club statistics
Computer systems/support
Cooking
Event coordinator
Graphic design
Finance/accounting
Fundraising
Marketing
Media relations
Medical support
Merchandise sales
Project management/planning
Publicity
Public speaking/outreach
Ride leader
SAG support
Web design
Working with youth
Writing
Profession
Accounting/Finance
Administrative/Clerical
Construction
Education
Engineering
Hospitality
Human Resources
Information Technology
Law Enforcement
Legal
Marketing
Medical
Sales
Web Design
Other
Are you interested in volunteering for the club?
Yes
No
Annual Membership Fees
Membership:
Individual Membership ($30)
Household Membership ($45)
30 Days ($10)
waiver
I hereby agree that I am the person stated above and have read and agree to the waiver
Method of Notification of Annual and Special Meetings
I consent to receiving notice of annual and special meetings of TCBC members at the email address currently on file for my membership
I do not consent to receiving notice of annual and special meetings of TCBC members at the email address currently on file for my membership
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