Membership Application for the Arizona Chapter of the Ford
Falcon Club of America
Dues: $24.00 Due January 1st (Pro-rated by month)
Payable to: The Arizona Ford Falcon Club (AFFC)
Address: c/o Reba Schweitzer
7203 W. Dove Roost Road
Queen Creek, 85242-9386
DATE ____________
NAME _____________________________________________________________________________________
NAME OF SPOUSE __________________________________________________________________________
ADDRESS __________________________________________________________________________________
CITY _______________________________ STATE ______________ ZIP _______________________________
TELEPHONE NUMBER _______________________________________________________________________
E-MAIL ADDRESS ___________________________________________________________________________
Are you a member of The Falcon Club of America? _____ Yes _____ No If
so, what is your member # _________
Are you willing to volunteer for club functions? _____ Yes _____ No
You are interested in: _____ Social Activities _____ Car Shows _____
Racing _____ Auto tech needs
_____ Other __________________________________________________________________________________
Do you presently own a Falcon? (Not required for membership) _____ Yes
_____ No
CARS YOU OWN:
-YEARS---BODY CODE--MODEL------CONDITION-----------------------------
________ ____________ __________ _______________________________________________
________ ____________ __________ _______________________________________________
________ ____________ __________ _______________________________________________
________ ____________ __________ _______________________________________________
________ ____________ __________ _______________________________________________
________ ____________ __________ _______________________________________________