SDMCC Membership Registration Form

SDMCC Membership

Use this form to join the Southern Districts Model Car Club
Application Date

DayMonthYear
This date is automatic and read only.
Name:*

First NameLast Name
E-mail:*
Mobile Phone Number
Occupation
Address:*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
How we communicate with you.

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Membership Type*

Family Group (2+2) - $100Senior Single Member - $80Junior Independent Member (Under 16) - Free
Other Family Members
Please supply the full names of other family members you want to include on this membership (max 3)

SDMCC Membership