THE MG CAR CLUB OF CENTRAL NEW YORK

Annual Membership Dues are $25.00 All Memberships expire December 31^st

NAME____________________________________________Birthday____________________

Spouse _______________________Friend_______________________ Birthday____________

Phone: Home _________________Work_________________ Cell _____________________     

Address__________________________________________City_________________________

State _________Zip___________ Today’s Date_________    New or Renewal? ___________

CARS OWNED & YEAR:

_______________________________________________________________________

INTERESTS: Racing____________Gymkhana____________Rallye____________Restoration___________

Car Show__________Social__________Touring_________Other_______________________

HOBBIES: ___________________________________________________________________

Occupation_______________   E-mail Address_______________________________________


Would you prefer to have the club newsletter mailed______ OR e-mailed_______ to you?

Can you assist other members with Roadside Help? Yes _______ No _______If so, when?

Days________ Evenings_________ Nights__________ Weekends ________Any time________

MAIL APPLICATION WITH CHECK PAYABLE TO:  
MG CAR CLUB OF CENTRAL NEW YORK

Mail to: MG Car Club of CNY
              Attention: Janet Moyer
              P.O. Box 1666
Cicero, NY 13039