Application to become an Associate Brother
in the Long Island Ravens MC

Your Name: 
Address: 
City:   
State:    Zip:    Telephone: 
Email: 

Date of Birth: 

Are you a member or past member of any other Back Patch, Leather, Fetish, or Motorcycle Club?  Yes No 
If Yes,  Club Name: 
Address: 
City: 
State:  Zip:
Club Telephone: 

Are you known by or are you related to any full Brother of the Long Island Ravens M.C.?   Yes   No 
If Yes,  Member name: 

How would you describe your past participation in the gay leather erotic interest community? Very Active  Moderately Active   Novice

Do you own or are you licensed to drive a motorcycle? (Owning a motorcycle is not a membership requirement)  Own  Licensed   Neither

It is our policy to normally publish the full name, pictures, and email addresses of associates to the LI Ravens MC in all our publications, including web pages, newsletters, journal, and newspapers, unless specifically informed otherwise.  See Conditions, Privacy.

Are you willing to have your name, picture and photographs published?
            Yes   No
If No, please provide a brief explanation; and suggest a pseudonym:

Please write a summary of why you are interested in joining the Ravens’ as an Associate.

By clicking the "submit" button below, I'm indicating that I have read the conditions required of Associate Brothers and I'm prepared to further explore membership further with the Club.

When you click "submit" below, a copy of this form automatically will be emailed to the Long Island Ravens MC.  Should you not hear from us in within 7-days, please email us President@LIRavensMC.org