“Preserving the Past for the Future”

Membership Application

Date

Name: 

Address: 

City:     State:    Zip: 

 Phone:  Cell: 

 Birthday 

 E-mail Address: 

 I prefer to receive my newsletter by:

Regular Mail or by E-Mail

 I am a:

 New Member           Renewal

 Member Since

***Membership Dues:  $20.00 per year – January thru December 

  I am a collector of: 

 Engines, Tractors, Trucks, Cars, or (Other)

 I would be willing to help on a committee yes  no

 What type of committee 

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