SNCTB Application Form

PO Box 594, Reno, Nevada 89504

MEMBERSHIP APPLICATION

Date: __________________ CTCI No. ______________

Name: _________________________________________ Spouse: __________________________________

Mailing Address: __________________________ City: ____________________ State: _____ Zip: _________

Physical Address: _________________________ City: ____________________ State: _____ Zip: _________

Residence Phone: _____________________________ Business Phone: ______________________________

Email Address: _________________________________

I own the following 1955, 1956, or 1957 Ford Thunderbirds.

Year: _____ Body Color: _____________ Top Color: ______________ License #: ____________ State: ____

DUES: Membership is individual and spouses are encouraged to join. Single membership is $12.00 per year and family membership is $24.00 per year, for husband and wife and non-voting age children. Dues are due and payable on January 1, and become delinquent January 31. New members dues are $1.00 per month per person for each month remaining in the calendar year at the time of application.

Membership in the Sierra Nevada Classic T'Birds requires membership in the Classic Thunderbird Club (CTCI). However, the spouse of the CTCI member is not required to join CTCI.

Enclosed are total dues for the current year in the amount of $______________.

Birthdays (month & day only): Name______________________________ Date____________________

Name______________________________ Date____________________

Month & Day of wedding anniversary:_________________________________________________________

Signature(s):__________________________________ _______________________________________