Last Updated: 08/15/07

NELA Associate Application

Want to become more involved with the New England Leather Alliance?
Make a $20 donation to NELA for an Associates Benefits Card (ABC)!

PLEASE MAKE YOUR CHECK OR MONEY ORDER IN U.S. FUNDS PAYABLE TO: "NELA"

Please print a hard copy of this page. When filling out the form, please print legibly.

Mailing Name: ____________________________________________

Address: ____________________________________________

City: _____________________ State: _____ Zip: ____________

E-mail: _______________________________     Phone (optional): (_____) ___________________

Name as it should appear on your card:________________________________

DEMOGRAPHIC INFORMATION (Optional)

Age:    ___ 18-29   ___30-39   ___40-49   ___50-59   ___60+

Gender:    ___Male   ___Female   ___Transgender   ___Other

Orientation:   ___Bisexual   ___Gay/Lesbian   ___Heterosexual   ___Pansexual

Check off any appropriate statements:

___ I would like to help with the Fetish Fair Fleamarket
___ I would like to help with the Scarlet Leather
___ I would like to work on education and outreach to the non kinky community
___ I would like to work on internal outreach to fellow kinksters
___ I would like to present my expertise at a demonstration/class. (Please enclose details with this application).


Please mail completed form (plus check or money order):

NELA
P.O. Box 35728
Brighton, MA 02135