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Totem Model A & T Ford Club Membership Application

New members must agree to abide by and uphold the Constitution and the Club Rules (Bylaws). A new member must be "sponsored" by two (2) present members (in good standing) and approved by the membership committee.

Please complete the Application for below,...print the form,....bring the completed form to the next monthly meeting (meeting dates are featured under the heading "Meeting Schedule" press the button on the left of your screen); present the completed form to our Treasurer at the meeting...along with your cheque in the amount of $35.00 payable to Totem Model A & T Ford Club...!

Club dues are $35.00 per year, effective December 1st of each year. Depending upon the month that you actually join, the membership fee will be prorated accordingly.

You also have the option to mail your completed form along with the required cheque to the totem Model A & T Ford Club at the address indicated below:

Last Name :_________________________________________

First Name :______________   Spouse's Name : ___________

Address : ___________________________________________

City, ________________________  Province : _____________

Postal Code : __________      Tele # : (604) ________________

 

Please list all your vehicles 25 years and older and indicate the present condition :

A - Restored       B - Original       C - Restoring   D - Unrestored

        Year                      Make               Model              Condition

1)__________________________________________________

2)__________________________________________________

3)__________________________________________________

4)__________________________________________________

5)__________________________________________________

(if you require additional space, please attach a separate sheet of paper to list balance of vehicles)

 

Applicant's Signature                                     Date

___________________________                 _______________

 

Signature Sponsor #1                                Signature Sponsor #2

__________________________               _____________________

 

Totem Model A & T Ford Club

c/o P.O. Box 18563

4857 Elliott Street

Delta, British Columbia

Canada, V4K 4V7