Mid-Michigan MOPAR Enthusiasts


    NAME :_______________________________________________________________________
    PHONE # :____________________________________________________________________
    ADDRESS :____________________________________________________________________
    CITY/STATE/ZIP :_____________________________________________________________
    EMAIL ADDRESS :______________________________________________________________
    VEHICLES :___________________________________________________________________
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    PREFER MEETING AT : Dealership    : _________
                      : Members  home : ________
                      : Restaurant    : ________
                      : Other         : _____________________________
    PREFER MEETING AT :          Day : ________________      Time : _____________
    PREFER CLUB CRUISES ON :     Day : ________________      Time : _____________
          TO : ____________________________________________________
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    PREFER CLUB CAR SHOW ON :    Day : ________________       Time : ____________
          AT : ____________________________________________________
             : ____________________________________________________
             : ____________________________________________________
             : ____________________________________________________
    COMMENTS : _________________________________________________________________
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