Information about the Chapter 

City (Area) & State where the new chapter will form.

City:

State :

Enter Chapter Type - Full or Provisional

Chapter Type:

Information about the Chapter President

First Name:

Middle Initial:

Last Name:

City:

State:

Zipcode:

Telephone number:

Email address:

Information about the Secretary

First Name:

Middle Initial:

Last Name:

City:

State:

Zipcode:

Telephone number:

Email Address:

Information about the Treasurer

First Name:

Middle Initial:

Last Name:

City:

State:

Zipcode:

Telephone Number:

Email address:

Information about the focus or intent of the chapter :

 Please explain how you feel becoming a chapter of Old Guard Riders Inc. would benefit your community.

By submitting this application, we, the perspective officers named above, attest that this chapter is not being organized in order to engage in any illegal activity and that we agree to abide by all Federal, State and local laws which regulate the activities of a 501C3 corporation and by all policies and guidelines as set forth by Old Guard Riders Inc.

Old Guard Riders Inc. reserves the right to request additional information, including the Social Security number, of any person listed on this application in order to verify the identity and character of that individual. Refusal to provide such requested information may be grounds to disqualify the Chapter Application.

For security purposes, please type the above: