Buffalo Soldier Membership Application

Personal Information
           
Last Name
First Name
M.I.
Street Address
 
Apt/Unit #
City
State
ZIP Code
Sponsor
       
Biker Name
       
Home Phone
       
Mobile Phone
       
E-mail Address
       
Birth Date
(mm/dd/yyyy)
Sex
M - F
Years of Riding experience
Date of Marriage
(mm/dd/yyyy)
Spouse’s Name
Emergency Contact Information
           
Last Name
First Name
M.I.
Street Address
 
Apt/Unit #
City
State
ZIP Code
Relationship
       
Home Phone
       
Mobile Phone
       
Motorcycle Information
           
Make
       
Model
     
Year
       
CC’s
       
State
       
Tag Number
       
Motorcycle Endorsement
Yes - No        
Insurance Info
     
           
Motorcycle Information
Autobiography
May this information be used on our Website?
Yes - No
Please explain why you are interested in becoming a member of the Buffalo Soldiers MC of North Carolina?

Before anyone is voted into the Club as a Prospective Full Member or a Stand Alone Associate Member they will pay for Colors and the required shirts of the season up front, ($90 Full Members and $80 Associate Members for Colors, around $52 for (4) pullover shirts and around $25 for Navy Dress shirt size Small to 4X !