Spouse Membership Application

Please fill this form out if you chose to fill out the information online and are not mailing the form to us.

Your Name: Birthday:

Spouse's Name: Birthday:

Phone: (Home) (Cell)

Cell Carrier: (ATT, Verizon, Sprint, etc.)

E-Mail Address:

SRA requires a Background Check due to our involvement with Children.
Have you ever been convicted of a Sex Crime or a Crime against Children?

How many years riding experience?
Valid License? YesNo

Member of any other Motorcycle Organizations? If so, please list them here:

*Persons wishing to be an active member in this association must be an active motorcycle enthusiast, must be sponsored by a current member in good standing, and must attend an interview by the Board of Directors. A Background Check will be done due to the liability for the work we do for Children. The President will approve and sign this application at that time. To become a "member in good standing", a new member should be familiar with and abide by, the SRA by-laws and also will be responsible to pay dues at that time. Dues are $25.00 per year for an individual, and $30.00 for a couple per year. Please make checks payable to "SOUTHSIDE RIDERS ASSOCIATION" and turn in to the Membership Director.

By signing, applicant is stating they have read the by-laws and agree to them:

Applicant's Signature Required:

Date: