MEMBERSHIP APPLICATION
ST. CLOUD ANTIQUE AUTO CLUB, INC.
NAME: last__________________________________first____________________________spouse___________________________
Date:__/__/____
Children under 18___________________________________________________________________________________
ADDRESS___________________________________city________________________state______zip_____________
EMAIL ADDRESS__________________________________________________
TELEPHONE(______) _________________________
Occupation: (No Business Names)__________________________________
DUES: one year Family (w/spouse&children under 18) $10.00
new member first year $20.00 or if your membership lapses for more then 1 year
$1.00 for mailed rosters
List your antique, street rod, and / or collector automobiles now owned:
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List other auto related collectibles of interest.