Bay State Marauders
MEMBERSHIP APPLICATION
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Application Date _________________________ ____ Yes, I want to apply for/renew membership in The Bay State Marauders ____ active membership ____ associate membership Name ________________________________________________________ Address_______________________________________________________ City _________________________ State _______ ZIP_________-_______ Phone ________________________________________________________ E-mail ________________________________________________________ Birth Date ____/_____/_____ Occupation(s) ___________________________________________________________ Hobbies/Interests ________________________________________________________ ________________________________________________________________________ Other leather, BDSM, sgl/glbt, or fraternal clubs or organizations you are involved in (please list): ________________________________________________________________________ ________________________________________________________________________ I verify that I am at least 21 years of age. I subscribe to the Bay State Marauders bylaws and will uphold the rules and vision as outlined. I also affirm that I live in the Boston area. Signature____________________________________ Date __________ All information provided will be held CONFIDENTIALLY within Bay State Marauders. No mailing list or information is ever shared or sold to any group or business. Bay State Marauders: PMB75, 398 Columbus Ave, Boston Ma. 02116 |
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