Post Office Box 1135

Toms River, NJ 08754-1135

WEBSITE: http://www.vintageautoclubnj.org/

VINTAGE AUTOMOBILE CLUB OF OCEAN COUNTY, INC.

2010 MEMBERSHIP* APPLICATION (Please Print Clearly)

Name_________________________________________________________________________

Spouse’s Name _________________________________________________________________

Street Address _________________________________________________________________

City, State, and Zip Code ________________________________________________________

Telephone Number ___________________________ Cell Number ______________________

Email Address ________________________________________________________________

I would like my newsletter to be sent via (check one):

Email ________ (you must include your email address on the above line)

Regular postal service _________

I am interested in helping the club with the following (check all that apply): ____ Car show operation ____ Club committees ____ Cruise/event coordination ____ Being an officer

* Please note that as a Vintage Auto Club member, you are not eligible for trophies at our annual show.

ANTIQUE / SPECIAL INTEREST CARS YOU OWN:

YEAR MAKE MODEL

1. ________________________________________________________________________

2. ________________________________________________________________________

3. ________________________________________________________________________

4. ________________________________________________________________________

DUES: $20.00 Per Year

Make checks payable to: Vintage Automobile Club of Ocean County, Inc.

Mail to: P.O. Box 1135, Toms River, NJ 08754-1135

_____ New Member _____ Membership Renewal (Renew by 1/31/10)