THE MG CAR CLUB OF CENTRAL NEW YORK

2012

Annual Membership Dues are $25.00 -- All Memberships expire December 31^st

^{The newsletter will be e-mailed to all club members.}

^{If you would like a hard copy each month  there will be an additional $5.00 charge for the year to cover postage and handling.}

Name____________________________________________Birthday___________________

Spouse______________________  Friend_______________________ Birthday__________

Phone: Home________________  Work_________________ Cell ____________________     

Address__________________________________________City__________________________

State__________  Zip___________ Today’s Date_________    New or Renewal?________

Cars Owned & Yr. _______________________________________________________________________

INTERESTS: Racing____________Gymkhana____________Rallye____________Restoration__________

Car Show_________Social_________Touring_________Other___________

Hobbies, etc._______________________________________________________________________

Occupation_____________    E-mail Address_______________________ 

Do you want the club newsletter mailed to you for the additional $5.00 charge? Y or N

Can you assist other members with Roadside Help? Yes_______No __________ 

If so when? Days_________Evenings_________Nights__________Weekends________

         MAIL APPLICATION WITH CHECK PAYABLE TO:  
          MG CAR CLUB OF CENTRAL NEW YORK
          
               Mail to: MG Car Club of CNY 
                            Attn. Claudia Dorion
                            P.O. Box 1666
                            Cicero, NY 13039