MG CAR CLUB OF CENTRAL NEW YORK
2016
Family Membership Application
Membership dues are payable at the January 2016 meeting
All current memberships expire on December 31, 2015
Annual Membership dues are $25.00
The Club newsletter will be emailed to all club members
[ ] NEW Member
[ ] RENEWING Member
MEMBER #1: _______________________________BIRTHDAY________________
Month Day
CELL PHONE: _______________________
EMAIL ADDRESS__________________________________________
MAILING ADDRESS: __________________________________ HOME PHONE: ____________
CITY: ________________________________ STATE: ________ ZIP: __________
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MEMBER #2: _______________________________BIRTHDAY________________
Month Day
CELL PHONE: _______________________
EMAIL ADDRESS________________________________
Cars Owned: (if more than 2, please place information on back)
________ ____________________________ ______________________
YEAR                   MAKE                                               MODEL
________ ____________________________ ______________________
YEAR                   MAKE                                               MODEL
Makes checks payable to
MGCCCNY and mail with application to:
Frank Gordnier
5881 Sugarbush Drive
Tully, NY 13159                                                                      click here for PDF version
THANK YOU