PIEDMONT BRITISH MOTOR CLUB
(FOUNDED JUNE 1994)
Membership Application/Renewal Form
Our Club is dedicated to the maintenance, preservation, and family enjoyment of English Motor Vehicles. Ownership of English motor vehicles is not necessary.
MEMBERSHIP FEE for NEW MEMBERS IS $15.00. New members who join between March and May will have membership annual renewal dues paid through May of the following year.
Dues are due in June of each year. The annual renewal fee for dues is $25.00. There is a $10.00 discount for dues paid prior to May 31st of each year.
Owner’s name: ____________________________ Spouse’s Name ___________________________
Owner’s Birthday: (D/M)____________________ Spouse’s Birthday: (D/M)___________________
Address: ___________________________________ City: ______________________ State: ______
Zip: _________ Home Phone: ____________________ Other Phone: _________________________
E-Mail Address: __________________________________________________________
Interest: □ Driving Tours □ Rallyes □ Tech. Sessions □ Other: ____________________________
Special talents/expertise that you would be willing to share: __________________________________________________
BRITISH MOTOR VEHICLES CURRENTLY OWNED
|Model||Year||Condition||Chassis or Commission Number|
Make Checks payable to: “PBMC”. Mail to: PBMC 663 Kenway Loop Mooresville NC 28117
(Rev January 2008)