MEMBERSHIP FORM

CLUB INFORMATION

Membership in North Texas Volkswagen Club is open to anyone with a VW powered vehicle. The purpose of the club is to promote the preservation, restoration, driving and Racing of VW's. Dues are $25 Annually, which includes a Club T-Shirt, Monthly Newsletter and discounts ad many of VW parts / Services sponsors. Renewal is $15 w/o T. You can buy extra T's anytime for $10. The Club meets at 7pm the 2nd Tuesday of the month at J. Gilligan's  400 E. Abrams in Arlington. (817) 274-8561

MAILING ADDRESS:
NORTH TEXAS VOLKSWAGEN CLUB
 P.O. Box 7194
Arlington, TX.
76005-7194

 For Info.
E-mail: r_thackerson@hotmail.com  or Phone: (972) 524-1461

ALL INFORMATION IS HELD CONFIDENTIAL TO CLUB AND IS FOR CLUB USE ONLY
PLEASE PRINT

Who introduced you to the club. __________________________________________________________________

Name. _______________________________________________________________________________________

Address.______________________________________________________________________________________

City ._____________________________ State._________ Zip ______-_____

Phone-(_    _)__________ Work/Cell  Phone-(_____)___________ Email address-____________________________

 T-shirt Size: S --- M --- L --- XL --- XXL --- XXXL  

Car (s) Year, Model, Description ___________________________________________________________________

_____________________________________________________________________________________________

Other  interest. ________________________________________________________________________________

If you prefer your T-shirt to be mailed please add $4  postage. Otherwise you can pick it up at any club function.

Make checks payable to: North Texas VW Club

_________________________________________________________________________________  _     _____________________

TO BE FILLED OUT BY CLUB OFFICERS  

 Dues Paid [Y] [N] / T-shirt Received [Y] [N] /  Membership Card Received [Y] [N]

 Mailed in [Y] [N] /  Date Rec. ________________ Expires __________________

New Member $25 / Renewal or Associate Member (Newsletter only) $15.00

Recd. By:| Pres. | V.P. | Sec.  |  Initial _________

1/05