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Vintiques Car Club of Yakima

....Street Rods never lose their COOL



RSContact

WELCOME TO THE VINTIQUES

Any person of good character interested in Street Rodding Activities is eligible for membership. The initiation fee is a one time fee of $15.00 + $30.00 annual dues renewable by February 1st of each year.

PRINT CLEARLY

Name ________-_______________ Bday (m/d)__________ Hm Phone (______)_____________

Address__________________________________City_______________State _____ Zip ______

E-Mail-Address ____________________________________ Cell (______)__________________

Place of Business ________________________________________________________________

Occupation ______________________________ Wk Phone (______)______________________

Hobbies or other interests _________________________________________________________

An Associate Member is a Spouse/SO (Significant Other) or Child (13-18) living in the home of a full member. It is not required a Spouse/SO or Child be an Associate to participate in Vintiques functions, however, it is required for him/her to have the right to vote or to be eligible to hold office on the Board of Directors. The annual fee is $10.00 per Associate due by February 1st of each year with no initiation fee.
Spouse/SO Name __________________________________ Associate $10 yes _____ no _____

Birthday (m/d) __________________________ Anniversary (m/d) _______________________

E-Mail Address ___________________________________ Cell (______)__________________

Place of Business _______________________________________________________________

Occupation _______________________________ Wk Phone (______)____________________

Hobbies or other interests ________________________________________________________

List Children under 18 living at home

Name ______________________________ B-day________ Associate $10 yes ______no______

Name ______________________________ B-day________ Associate $10 yes ______no______

Name ______________________________ B-day________ Associate $10 yes ______no______

Name ______________________________ B-day________ Associate $10 yes ______no______

List your Street Rods or Classic Autos

#1 Year _____ Make ________________ Model _______________________ Complete _____%

Circle all that apply: Streetable Used for Rod Runs Parades Car Shows Other_______________

#2 Year _____ Make ________________ Model _______________________ Complete _____%

Circle all that apply: Streetable Used for Rod Runs Parades Car Shows Other_______________

#3 Year _____ Make ________________ Model _______________________ Complete _____%

Circle all that apply: Streetable Used for Rod Runs Parades Car Shows Other_______________

#4 Year _____ Make ________________ Model _______________________ Complete _____%

Circle all that apply: Streetable Used for Rod Runs Parades Car Shows Other__________________

Who told you about the Vintiques ___________________________________________________

Reason for wanting to join the Vintiques ______________________________________________

Other Clubs or Affiliations __________________________________________________________

Return completed form and required dues to:
Nancy Baisinger, 5107 N. Sky Vista Ave, Yakima, WA 98901-4303 (509) 910-1148

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