Membership Signup

The following information will be electronically submitted to the Membership Committee. IOMGIA reserves the right to deny or revoke membership in accordance with the Association By-Laws.

New and Renewing Members will be required to submit a photocopy of their agency issued credentials via fax or email.

Membership fee is $35. Your application will not be approved until payment is received and your photo id is verified. After completing the form below you will be given access to the online payment page.

Name(Required)

First Last

Agency(Required)

Rank / Title / Position(Required)

Agency Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Work Phone(Required)

Personal Phone(Required)

Email(Required)

Enter Email Confirm Email

Supervisor's Name(Required)

Supervisor's Email(Required)

Membership Status(Required)

Are you now or have you ever been a member of a motorcycle club?(Required)

If yes, what club?(Required)

I understand I have to submit payment for my membership along with my application(Required)

Date

Submit copy of official agency identification card(Required)

Acceptable file types: doc, pdf, txt, gif, jpg, jpeg, png

Max. file size: 8 MB.

Enter name of person filling out this form(Required)

Do you have any notes / comments for the Membership Committee?(Required)

Please let us know what's on your mind. Have a question for us? Ask away.

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