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West Coast Magna Membership Registration Form

Please fill out the required minimum information in the form below. These fields represent what we feel is the most basic information we need to make memberships useful to WCM, and each member. The first name is for WCM admin use only. State and ZIP will be used for searching and matching when members are looking for other riders in their area. Email is for WCM Admins and oter members to contact you using online forms. Your Email Address Will Not Be Displayed On The WCM Site. When you have completed this Basic Form, your basic membership is created. You will be taken to the Advanced Membership Form where you can refine your membership information and personalize in detail - but it is all optional. Please start your membership below.

First Name:
Last Name:		(optional)
State:		Select Your StateAL * ALABAMA AK * ALASKA AZ * ARIZONA AR * ARKANSAS CA * CALIFORNIA CO * COLORADO CT * CONNECTICUT DE * DELAWARE DC * DISTRICT OF COLUMBIA FL * rashelRIDA GA * GEORGIA HI * HAWAII ID * IDAHO IL * ILLINOIS IN * INDIANA IA * IOWA KS * KANSAS KY * KENTUCKY LA * LOUISIANA ME * MAINE MD * MARYLAND MA * MASSACHUSETTS MI * MICHIGAN MN * MINNESOTA MS * MISSISSIPPI MO * MISSOURI MT * MONTANA NE * NEBRASKA NV * NEVADA NH * NEW HAMPSHIRE NJ * NEW JERSEY NM * NEW MEXICO NY * NEW YORK NC * NORTH CAROLINA ND * NORTH DAKOTA OH * OHIO OK * OKLAHOMA OR * OREGON PW * PALAU PA * PENNSYLVANIA RI * RHODE ISLAND SC * SOUTH CAROLINA SD * SOUTH DAKOTA TN * TENNESSEE TX * TEXAS UT * UTAH VT * VERMONT VA * VIRGINIA WA * WASHINGTON WV * WEST VIRGINIA WI * WISCONSIN WY * WYOMING WC * WESTERN CANADA EC * EASTERN CANADA (Canadians - check end of list)
Zip Code:
Valid email:		(Privacy Policy) This must be a vaild email address. It will be WCM's method to contact you. It will NOT be displayed on the WestCoastMagnas.com site.
WCM Screen Name:		Minimum of 3 characters This is the name we'll use in any postings or articles related to WestCoastMagnas.com. You may want it to match your MRA, Delphi or v4hondabbs screen name.
WCM Password:		Minimum of 6 characters
Membership Type:		Please Select The One That Applies To You
Standard Member		Select Standard Member if you own/ride a Magna AND you live/work in the WCM Primary Member Area
Associate Member		Select Associate Member if you are a relative or dependent of a Standard Member OR you do not own/ride a Magna, but do own/ride another motorcycle (and like Magnas) OR you own/ride a Magna but live outside the WCM Primary Member Area
Affiliate Member		Select Affiliate Member if you are a motorcycle related business OR you are a motorcycle group, forum or other entity AND you will contribute $25 per year to WCM to help fund WCM activities Read more about Affiliate Member rules and benefits by clicking here