Pocono Mountains Buffalo Soldiers Motorcycle Club

Membership Application

Buffalo Soldiers Membership Application

PLEASE FILL IN ALL INFORMATION

Age:

Street Address:

City/State/Zip Code:

Home #: Cell: Business#:

E-Mail Address:

Emergency Contact Name:

Emergency Contact #:

Please give a brief history of yourself (including military service, current employment, and membership in other motorcycle clubs:

Are you legally licensed to operate a motorcycle? Yes No

If you currently own a motorcycle please provide the following:

Type: Model: Year: CCs:

Years of riding experience:

Explain why you are interested in becoming a member of the PM Buffalo Soldiers Motorcycle Club.