:: Crusaders MC of Virginia ::

Application

Acting Crusaders Motorcycle Club is an Equal Opportunity that does not discriminate against any applicant of race, color, religion, sex, age, or national origin.

Full Name:
Email Address:
Address Number and Street:
Address City:
Address State and Zip Code:
Telephone Home and Work:
In Case of Emergency Notify:
Years of street riding:
Type of motorcycle:
Do you have current license with Class M? (Yes or No)
Have you ever been denied membership to a motorcycle club? (Yes or No) If yes, please explain why
Referred to the club by: (Club member, Non-Member, or Other)
Will you abide by all the rules and regulations of the club? (Yes or No)