Typ 356 Northeast is dedicated to the preservation and enjoyment
of theRegistration 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:
Ron Swenson Typ356NE
Typ356 Northeast
Membership Chairperson
81B Warren St.
Charlestown, MA 02129
(home) 617.242.9213
rswenson@typ356ne.org