Bay State Marauders

MEMBERSHIP APPLICATION

Yes, I want to apply for / renew membership in The Bay State Marauders Active Membership Associate Membership
Name	Birth Date
Address
City	State ZIP
Telephone
Email
Repeat email
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. Application 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

Form updated 08/16/2006

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