Lions Gate Model A Club
Dedicated Model A enthusiasts from across
British Columbia and Washington State!
Please print the application form and complete as requested. Annual membership is $40.00 per calendar year, effective October 31st. Depending on the month you join, the membership fee is prorated. If you have a question, please direct your questions to aglen@lionsgatemodelaclub.com
Name:_____________________________________________________ |
||||
|---|---|---|---|---|
Address:___________________________________________________ |
||||
City:______________________________________________________ |
||||
Province or State:____________________________________________ |
||||
Postal or Zip Code:___________________________________________ |
||||
Phone Number:______________________________________________ |
||||
Email Address:______________________________________________ |
||||
Please list all Model A vehicles you own. |
||||
Year |
Model |
U (unrestored) |
R (restored) |
Engine Serial # |
1._________________________________________________________ |
||||
2._________________________________________________________ |
||||
3._________________________________________________________ |
||||
4._________________________________________________________ |
||||
I the undersigned agree to abide by and uphold the Constitution of ___________________________________ Date: _______________________ Please mail your application form with payment to: |
||||
Lions Gate Model A Club Box 658, 800 - 15355 - 24th Ave Surrey, British Columbia V4A 2H9 |
||||
Web Design by CRB , All content © 2010 Lions Gate Model A Club |
||||