TIMELESS CLASSICS CAR CLUB
Membership Renewal
Date__________________
Member #1 Name_________________________________
Birthdate Month________________________________
Member #2 Name________________________________
Birthdate Month________________________________
Address______________________________________________________
E-mail address________________________________________________
(please submit your E-mail address so we can control the cost of postage)
Phone #____________________________________________
Single Membership______x $20.00=_____________
Family Membership______x $25.00=_____________
(family membership is applicable to all persons residing at the same address)
Amount submitted for renewal membership____________
Treasurer___________________________________________
Send all forms and money to Treasurer: Keith Wagner, 8624 Armitage Rd., Lyons, N.Y. 14489
PLEASE, fill out the renewal forms completely. The Secretary needs all the information for her records. You need to fill out a new form each year.
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