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Please print information as you wish it shown in the roster and on the mailing list. |
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Member's Name |
____________________________________________________ |
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Spouse's Name |
____________________________________________________ |
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Address |
____________________________________________________ |
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City |
____________________________________________________ |
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State |
____________________________________________________ |
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Zip/Postal Code |
____________________________________________________ |
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Home Phone # |
( _____)______________________________________________ |
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Work Phone # |
( _____)______________________________________________ |
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Fax # |
( _____)______________________________________________ |
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E-mail Address |
____________________________________________________ |
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Check here if you do not wish to have your name included in the roster (not recommended) |
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Please send this application and a check for $24.00 (payable to Motorcar Operators West) to:
Motorcar Operators West
8672 Fairmont Way
Fair Oaks, CA 95628
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