Click on the button to the right for an
application that can be printed out ▬►
Inland
Empire GTO Club New Member Application
Name: _______________________________________________ Today’s
Date____________________
Spouse’s or Significant Other’s name:
_____________________________________________________
Street Address:
_______________________________________________________________________
City:
_________________________________________
State: _____________
Zip: _____________
Phones
Home: ____________________
Cell: __________________________ Work: ____________________
Email
Address________________________________________________________________________
Birthday: _______________ Spouse’s Birthday: _________________
Anniversary________________
Vehicles
Year: ___________
Make: ____________________________
Model: ________________________
Year: ___________ Make:
____________________________
Model: ________________________
Year: ___________ Make:
____________________________
Model: ________________________
Year: ___________ Make:
____________________________
Model: ________________________
This information is requested
for club use only. We do
however, publish a roster on our website and like to include all members.
Please indicate if your information can be published with the others:
|_| Publish telephone number
and email address with other member’s information
|_| Publish only Names
to those individuals who have an avid interest in Pontiacs, agree to abide by
the bylaws of the club, and
agree to conduct themselves in accordance with the family oriented nature of the
club. New members
must submit with their application the annual club dues of $20.00 which also
includes the immediate family
of member. Please print and
complete this application. Mail the
completed application to:
Inland Empire GTO Club
New Member Application
5801 Quiroz Drive
Riverside, CA 92509