Thunderbird Circle, Orange County
Chapter 78 of Classic Thunderbird Club International
Membership Application: □New □Renewal
www.thunderbirdcircleoc.com
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First Name Last Name Spouse/Significant Other
______Address City Zip
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Home Phone Cell Phone Email Address
Optional: Your Birth Date _____/_____ Spouse/Significant Other’s Birth Date _____/_____ Anniversary _____/_____
(month/day) (month/day) (month/day)
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Year of Bird Body Color Top Color Interior Color(s)
Is your Thunderbird: (circle all that apply) Show Car Driver Awaiting Restoration Stock Customized Modified
Is your Thunderbird ready for display or concourse? Yes_____ No_____ N/A_____
Other information of interest concerning the restoration of your Thunderbird: Please include any work you or others had
to do to the Thunderbird.
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Have you attended a Thunderbird Circle, Orange County meeting or event? Yes_____ No ____
If yes, please provide name of event and date: ______
Who is sponsoring you (If any)? ______
(Member’s Name)
Are you a member of Classic Thunderbird Club International (CTCI) Yes □, No □, If yes, CTCI#______
Membership Agreement: With my signature provided below I/we the above named applicant(s) do hereby release and hold harmless The Thunderbird Circle, Orange County, Chapter 78 and its national organization, CTCI, from any damage(s) and/or any injury to applicant(s), applicant’s guests and/or applicant’s vehicles or applicant’s guests vehicle, arising from any function or activity of this organization or its parent organization. Any and all vehicles driven to any function of The Thunderbird Circle, Orange County, Chapter 78 and its national organization, CTCI, must carry the State of California required Insurance as specified in California Vehicle Code Section 16020 or equal.
Signature: Date:
Signature: Date:
Membership dues are $35.00 a year and are due and payable on January 1st. If you are a new member and just joining, dues are prorated to the quarter of the year. If you are joining the club after May 31, June 30 or September 30, the dues are $8.75 for each remaining quarter year remaining in the calendar year plus the initiation fee. All new members are required to pay an additional one time initiation fee of $15.00. Please make check payable to Thunderbird Circle, Orange County or TCOC.
Mail to: Tom Peluso, Membership Chairman 951-746-3375 or 949-533-7357
30585 Rattle Dance Way email:
Menifee, CA 92584-9328 email:
for office use
Date Accepted ______Membership Number ______Filed ______
rev. 10-2013 bd