APPLICATION

APPLICATION

(required to apply or renew)


ROYAL PONTIAC CLUB OF AMERICA INC.

(PLEASE PRINT CLEARLY)

 

We are always looking for new members with ANY model car who enjoys classic cars,

making new friends, drag racing, cruising, tech advice or want to help others.
 If you or anyone you know would like to join, fill out the form below and return it to:

                

ROYAL PONTIAC CLUB OF AMERICA INC.

P.O.BOX 252402

WEST BLOOMFIELD, MI. 48325

 

Please make checks payable to the Royal Pontiac Club of America Inc.

Dues are $25.00 yearly. January to December. Sorry no prorating. 

 

___I want to join, here is my check.                                         ___Here’s my renewal.

 

Expiration Date________________                                       Member Number________

 

Name _________________________________________________________________

 

Address________________________________________________________________

 

City______________________________________State________Zip Code__________

 

Home phone (        )___________________________Work Phone (       )_____________

 

EMAIL (required)________________________________________________________

 

                                           List Performance / Classic Car

YEAR             MODEL                   BODY                ENGINE SIZE   TRANS

 

___________________________________________________________________

 

___________________________________________________________________

 

___________________________________________________________________

 

___________________________________________________________________

 

I agree that if elected to the membership, I will conform to all rules of the Royal Pontiac Club of
America, Inc. and to conduct myself in a manner that promotes the purposes of the organization.

 

SIGNED_____________________________________DATE________