2007 SMC Membership Form
To assist with record keeping, please fill
out this application and mail it or bring it to an upcoming meeting along with
the dues. Please be sure to include all information and you’ll save the club
mailing cost if your newsletter can be e-mailed to you. Thanks, Bill
Name ____________________________________________ Spouse’s Name _________________
Address __________________________________________________________________________
City _______________________________________ State __________ Zip Code ______________
Phone (_____) ____________________ E-Mail Address __________________________________
Would you like to have your newsletter and club information e-mailed to you? [ ] Yes [ ] No
Mustang(s)
Owned
Year
Body Style
_________
__________________
_________ __________________
_________ __________________
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Club Dues
$20.00 Annually (for family membership)
Are you a
member of the Mustang Club of America? Yes/No
Make Checks
Payable and Mail Application to: Suncoast Mustang Club
c/o Bill Dellert, Treasurer
6705 Cardinal Drive South
St. Petersburg, Florida 33707-3803
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Additional Voluntary Information
Birthdays: Name __________________ Month/Day ____________
Name __________________ Month/Day ____________
Name __________________ Month/Day ____________
Wedding Anniversary Month/Day _______________
Suggestions for Programs, Presentations, Social Activities: