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Name ____________________________________________ Spouse ____________________
Address _______________________________________________________________________
City _______________________________________ Province __________________________
Postal Code ______________________________
Phone (_______)__________________________
Email Address __________________________________________________
Year of vehicle ________ Make ______________ Model
_______________________________
Body Color ______________________________ Interior Color __________________________
Engine _________________________________ Miles _________________________________
Options and Special Features
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
How long have you owned your vehicle? _____________________
Other Comments_________________________________________________________________
All information is considered
confidential and is used for club purposes only.
No information will be released without the prior consent of the member.
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