2008 MEMBERSHIP APPLICATION

From the classics, antiques and muscle cars
to the new spirit of performance and beyond.

Our purpose is to promote the preservation and restoration of motor vehicles produced by Chrysler Corporation and to provide a common meeting place to accomplish the purpose of the organization and promote goodwill among themselves and their sport.

Membership Dues:

Single:            $30.00 CDN
Couple:           $35.00 CDN
Family:            $40.00 CDN
Newsletter Mail-Out: $15.00

Please Fill Out The Form Below, Print It, And Send It With Your Check To 

Mopars Unlimited Car Club
Suite #239- 800
15355 24th Avenue
Surrey, B.C.
V4A 2H9

Full Name Today's Date     New Renewal

Address

City Province/ State Please Select British Columbia Alberta Washington Postal /Zip Code

E-Mail

Phone (work or cell) Phone (home)

Occupation     Age  Please Select 18 to 25 26 to 30 31 to 35 36 to 40 41 to 45 46 to 50 51 to 55 56 to 60 61 to 65 66  to 70 71 + 76 to 80

Make & model of driveable car(s)

Make & model of car(s) under construction

Would you be interested in a staff or committee job? Yes No

What special skills do you have that might benefit the club?

Do you wish to be contacted for events? (eg. cruises, poker runs, car shows, etc) Yes No

Membership entitles you to the following: Membership Card, Club Window Decal, ( new members only) parts discounts at participating dealers and businesses, and free ads in our newsletter and club website www.moparsunlimited.net .

Club meetings are held the third Wednesday of each month at Ricky's Restaurant in Walnut Grove 8730 204th St. (just east of 200th Street off 88th Avenue in Langley). Meetings start at 7:30 PM and run approximately 1 1/2hrs.

Mopars Unlimited Car Club
Suite #239- 800
15355 24th Avenue
Surrey, B.C.
V4A 2H9

How did you learn about us?

Please Select One Friend Club Member Internet Car Show