OKC/WEST REGION
MEMBER
APPLICATION
FULL NAME
AGE
PHONE NUMBER
STREET ADDRESS
CITY
ZIP
EMAIL
CONFIRM EMAIL
Have you been convicted of a felony?
No
Yes
Do you consent to a Background Check?
Yes
No
If you answered "YES" to the above felony question, Please list them here.
*A felony conviction does NOT necessarily disqualify you,
but failure to disclose them now may.
Are you familiar with the term "Western Chauvinist"? Do you consider yourself to be one?
Why do you want to be a Proud Boy?
Please upload a copy of a Photo ID or Passport.
Max file size 10MB. Must be in JPG, PDF, PNG or IMG format.
UHURU