MEMBERSHIP FORM (Click BLUE Button).

2018 CAR SHOW Registration

   PPPCC




2018 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.

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CLUB
USE ONLY

Date
received:_______________________Dues(amt):__________________________

Member number:_____________________
exp. 02/01/19