“CIMARRON STARLITE CRUISERS’ CAR CLUB”

MEMBERSHIP APPLICATION

(Please Print)

Member Name Last First Middle Initial Date of Birth

Spouse Name Last First Middle Initial Anniversary

Mailing Address City State Zip

Home Phone number Cell Phone number

Email Address

How did you learn about the Cimarron Starlite Cruisers’ Car Club? And what are your reasons for joining?

(Social events, Car Shows, Technical Information, Meeting and Gaining New Friendships, etc.)

______

DESCRIBE YOUR CAR OR TRUCK (S)

Year Make & Body Style Engine Transmission Color

Year Make & Body Style Engine Transmission Color

Year Make & Body Style Engine Transmission Color

Year Make & Body Style Engine Transmission Color

Signature Date

MEMBERSHIP DUES: $25.00 Per Year Due April 1

MAIL TO: Cimarron Starlite Cruisers, PO Box 362, Perkins, OK 74059

WEBSITE: http://slauener.tripod.com “Cimarron Starlite Cruisers’ Car Club”