2017 CAR SHOW Registration






                                                                       MEMBERSHIP APPLICATION
                                                                    Pacific Performance Pontiac Club Vancouver BC Canada
                                                                                                  P.O.Box 24  Maple Ridge
                                                                                                    BC  V2X 7E9   Canada

(Please print this page and complete in full )


Name:____________________________________
Spouse/Mate:____________________________

Address:________________________________________________________________

City:_________________________________Prov/State:________________Postal
Code/Zip:_______

Phone:________________________Country:_________________________Date:_________________

Email:________________________________________________

Pontiac's Owned:

Year:___________Model:_________________Style:_____________________

Year:___________Model:_________________Style:_____________________

Do you object to being listed in a
Club Directory for members? Y / N

Other Car Club
Affiliations:_____________________________________________________

How did you learn of Pacific
Performance Pontiac Club?______________________________

____________________________________________________________________________

Please indicate any areas of
interest or expertise you could make available to the club or
members?____________________________________________________________________

____________________________________________________________________________

Signature:_________________________________

Dues are $30.00CDN per year
pro-rated to Feb 1st. Please contact Membership Chairman for details.

***********************************************************************************

CLUB
USE ONLY

Date
received:_______________________Dues(amt):__________________________

Member number:_____________________
exp. 02/01/15

 

MEMBERSHIP FORM (Click BLUE Button).

   PPPCC