Bay State Marauders
MEMBERSHIP APPLICATION

 

Back to Documents page


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
PO Box 301541
Jamaica Plain, MA 02130


Back to Documents page