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MEMBER APPLICATION

Url

First Name

Last Name

Home Phone

Mobile Phone

Email Address

Street Address

City

State

Zip Code

Car you presently own? (Must be 1972 or older, registered, and drivable).

Current Club Affiliations

Years interested in restoration

Are you willing to attend club meetings regularly? *

Yes

No

What is your experience in restoration?

Who is your club sponsor?

Your Date of Birth

Spouse Date of Birth

Wedding Anniversary

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