SHENANDOAH VALLEY MOPAR CLUB

www.geocities.com/shenvalmopar/Main  

2008 MEMBERSHIP APPLICATION

 

NAME: _______________________________________ EMAIL: ____________________

 

ADDRESS: __________________________________________________________________

 

           CITY: ____________________________STATE: ________________ZIP CODE: _________

           PHONE (Home): _______________________PHONE (Work): ________________________

           SPOUSE/GIRL FRIEND/BOY FRIEND NAME: ____________________________________

           CHILDREN'S NAMES: ________________________________________________________

 

MOPARS OWNED:

           YEAR: ______________________  MAKE: _____________________MODEL: ___________

 

           ENGINE: ______________________STOCK or MODIFIED: ______________________

 

           COLOR (Exterior): ______________________COLOR (Interior): ______________________

 

SPECIAL FEATURES/OPTIONS:_________________________________________________

 

________________________________________________________________________________

 

           HOW DID YOU HEAR ABOUT THE S.V.M.C.?

DO YOU NEED HELP WITH ANYTHING, OR ARE THERE SERVICES WOULD LIKE TO OFFER TO OTHERS?

 

(Please list additional MOPARS that you own on the back of this form.)

 

 

The Shenandoah Valley Mopar Club is open to all persons who are the proud owners of MOPARS or to those persons who have a great love and appreciation for these grand vehicles. Club dues are $20.00 per year for membership. Meetings are held on the 2nd Sunday of each month. For additional information, please call Donnie Sweet at (540)337-4310, Linda Lipscomb at (540) 290-5648, or John Manson at (540) 746-2431

Email: [email protected]

 

*NOTE:     APPLICATION'S MUST BE ACCOMPANIED BY A CHECK MADE PAYABLE TO THE SHENANDOAH VALLEY MOPAR CLUB

 

Mail Payment to:                            

 

SHENANDOAH VALLEY MOPAR CLUB

c/o Donnie L. Sweet

2144 Stuarts Draft Highway
            Stuarts Draft, VA  24477