Do you have an interest in development and interchange of technical, historical, social, and/or other information for and/or among members who OWN, or are INTERESTED in Antique, Classic, Custom, Hot Rods, Muscle Cars, Replicas and Special Interest Vehicles, etc?

Name ___________________________ Spouse ______________________

Email __________________________ Spouse's Email __________________

Address ________________________ City/State/Zip ____________________

Phone#__________________________ Cell#(optional)_____________________

Please list any special interest vehicles that you may own: __________

_______________________________________________________________________

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Annual dues are $20.00 for individual or $30.00 for your family. Pro-rated at $2.50 per remaining numbers of months in the year after March. By signing this application you agree to abide by the club by-laws and to help your club with various events when possible. I understand that I am responsible for my own automobile insurance.

Signature: __________________________ Date: ____________