Chapter Application Form Old Dogs Brotherhood
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Last Name:___________________________________________________________________________
First Name:________________________________________Club Name__________________________
D.O.B. ___month________day____________year__________________________________________
Address:____________________________________________ Zip:______________________________
State: ________________________________________________________________________________
Phone:_________________________Cell:___________________________________________________
Why you want to be an Old Dog __________________________________________________________
E-Mail:_______________________________________________________________________________
Bikes__________________________________________________________________________________
Previous Clubs & Dates:__________________________________________________________________
Club Tattoos __________________________________if Yes Where_______________________________
________________________________________________________________________________________
P.O.Box 341 Blakeslee, Pa. 18610-0341


Old Dogs Brotherhood Resignation and Expulsion Agreement
UNDERSTOOD: As founder of Old Dogs Brotherhood, Little Richard will always remain as Old Dogs Brotherhood
Executive President.
Old Dogs Brotherhood, ODB
With your notarized signature of this Resignation and Expulsion Agreement both the Old Dogs Brotherhood (ODB) and
the member agree to the following:
A: If I resign or am expelled I will immediately cease and desist from all association and activities of the Old Dogs
Brotherhood (ODB).
B: The denim vest with “member designated patches: (including your personal patches, which will be returned to you)
and any other clothing with the ODB insignia (ex. T-shirts, or fleece) must be returned in their original condition,
excluding normal everyday wear, within twenty (24) hours of the resignation or expulsion to the local Chapter of ODB.
The local Chapter will return the items to the President, Vice President or Financial Officer/Secretary of Mother
Chapter ODB within seventy two (72) hours of receipt of the items. (ODB will provide you with a list of ODB
property/items that must be returned). This includes, but not in its entirety the Denim Vest, Center Back
Patch/Colors, Chapter Patch, POTW patch, Property of and Product of patch. Failure to promptly return ODB items as
per this agreement will result in legal action and a $650.00 fee for each set. I agree that all disputes will be settled in the
“Monroe County, PA.” Court System.
C: I agree to relinquish all rights to refund of fees and contributions to ODB.
D: I agree that I will not have any right, interest or claim of any assets of ODB.
E: (Important) Since all member patches and garments with the ODB emblems/insignia is “Copy Righted” they must
be leased through the ODB Mother Chapter. This lease will be for the duration of time you are a member and in good
standing. These patches and insignias remain the property of ODB Mother Chapter. The acquisition of ODB
patches/insignia through any other unauthorized source is illegal and will be prosecuted. Also, colored back
patch/insignia is only allowed on denim vests. Only one vest is provided or allowed to a full member.
I have read and understand the By-Laws of the Old Dogs Brotherhood and will abide by these by-laws. I further agree to
abide by the terms of this Resignation and Expulsion agreement.
Printed Name ___________________ Signature____________________
Date __________________
Notary Public ________________________________________________
(Once signed and notarized make and keep a copy for yourself.)
As of June 16, 2010 this will be the only Colors,
Resignation and Expulsion Agreement that will be
accepted for membership.