Typ 356 Northeast is dedicated to the preservation and enjoyment
of the
Registration Form for Typ 356 Membership
| Name | _________________________________ |
| Address | _________________________________ |
| _________________________________ | |
| _________________________________ | |
| Phone | _________________________________ |
| Work phone | _________________________________ |
| Mobile phone | _________________________________ |
| Fax | _________________________________ |
| _________________________________ | |
| *(very important as we communicate mostly via e-mail) | |
| Spouse/Associate members name | _________________________________ |
| Vehicle(s) (year, model, body style) | _________________________________ |
| _________________________________ | |
| _________________________________ | |
| Please let us know your interests: | |
| [ ] rallies/racing | [ ] club touring |
| [ ] tech sessions / restoration | [ ] social events |
| other interests | _________________________________ |
| Would you like to help with: | |
| [ ] events | [ ] newsletter |
| other | _________________________________ |
| Occupation (optional) | _________________________________ |
(Office use only - member # __________________________)
Print this form, fill it out, and mail it along with your club dues to:
Allen Sisson Typ356NE
Membership Chairperson
11 Spruce Way
Medfield, MA 02052
(home) 617-921-0532
asisson@typ356ne.org