Blood Sweat and Gears
     MEMBER  APPLICATION

Last name __________________ First name ____________ Spouse ____________

Preferred names _____________________________________________________

Address __________________________ City _____________ State ___ Zip ______

Home phone ______________ Work phone ______________ Cell ______________

E-mail:______________________________________ We will E-mail your newsletter.

Birthday ____________ Spouse birthday ____________ Anniversary ____________

Special vehicle owned: ________________________________________________
					year, make and body style

Special vehicle owned: ________________________________________________
					year, make and body style

Special vehicle owned: ________________________________________________
					year, make and body style

By signing and submitting this information, I affirm that all statements are true and if accepted,
I will support the Blood Sweat and Gears car club in a safe and responsible manner at all times.
With this application is $25.00 ($12.50 if under 21) representing membership dues for current year from January 1st to December 31st.  New members pay $12.50 if joining after June 30th.
Any of the above information may be published in the club newsletter.
Dues are due January 1st each year.  You are encouraged to attend meetings.
The meetings are on the second Tuesday of each month.

You are welcome to attend the meetings before joining.

Signature ____________________________________ Date _________________

Sponsored by __________________________

Dues paid_________ (Treasurer initials), Date ______________

Document by 2002 club President: CharlesT

Blood Sweat and Gears    PO Box 1421    LaSalle, Illinois 61301