SANTA ANITA'S MEMBERSHIP APPLICATION

SANTA ANITA'S MEMBERSHIP APPLICATION
CLUB INFORMATION: THE SANTA ANITA A’s meet the last Saturday of every month, (December Mtg. replaced by Holiday Party), at The Church of the Good Shepherd 400 W. Duarte Rd. Arcadia 91007. 9:00 AM
Owning a Model A Ford is NOT a prerequisite for membership.Anyone interested in the Model A is welcome. Technical Seminars and information are available to members. In addition,many club tours, picnics and parties are planned throughout the year.Most activities are family functions, so bring the whole family.

THE SANTA ANITA A's meet the last Saturday of every month, (December Mtg. replaced by Holiday Party) at The Church of the Good Shepherd 400 W. Duarte Rd. Arcadia 91007. 9:00 AM Owning a Model A Ford is NOT a prerequisite for membership. Anyone interested in the Model A is welcome. Technical Seminars and information are available to members. In addition, many club tours, picnics and parties are planned throughout the year. Most activities are family functions, SO bring the whole family.Church of the Good Shepherd.For more information visit our Website: https://www.santaanitaas.org/
For more information, visit our Website:http://www.santaanitaas.org
Current Date*

MonthDayYear
Date
Name (First Last)*
Birthdate MM/DD*
Spouse's Name
Spouse's Birthdate MM/DD
Wedding Anniversary Date MM/DD
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone
Format: (000) 000-0000.
Cell Phone
Format: (000) 000-0000.
EMail Address*
example@example.com
Fax
By checking this box, I am allowing my Name and Phone #, to be published in the Spoken Wheels, prior to release of our January Roster.
YES
Current Model A's owned:
Mode A Year
Body Style
Running
Mode A Year
Body Style
Running
Mode A Year
Body Style
Running
Model A Year
Body Style
Running
SANTA ANITA A's Yearly Dues. ( $ 40:00 thru June, $20:00 July thru end of year)**

Optional: MODEL A FORD CLUB of AMERICA $50, Yearly Dues *

** (People joining in December, ($40.00) will have their dues applied to the following year * The Santa Anita A's encourage you to join the Model A Ford Club of America (MAFCA However, it is not required. Membership in MAFCA does entitle you to an annual subscription to the award winning Restorer Magazine.
Santa Anita A's Membership ($40/$20*)MAFCA Membership ($50) (Optional)
TOTAL PAID*
SANTA ANITA A's Membership Name Badges: Your name badge will be provided by the Club as part of your membership. Wearing it to our general monthly meeting, entitles you to be in the badge drawing for a prize. Please Print your First and Last Name as you want it to appear on the Badge:
Membership Name Badge 1
Membership Name Badge 2
Are you currently a member of another Car Club?
MAFCAMARCMAFFISGV/MARCMATCFAST
OTHER
When you submit this Application it will go to our Membership Chairman.

Please make out a check to the 'Santa Anita A's' for the total amount and send that to our Membership Chairman.

Randy Harper

308 E. Hillcrest Bl.

Monrovia, CA 91016

Ph # 626 357-6442

Email: randy308@earthlink.net
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SANTA ANITA'S MEMBERSHIP APPLICATION

CLUB INFORMATION: THE SANTA ANITA A’s meet the last Saturday of every month, (December Mtg. replaced by Holiday Party), at The Church of the Good Shepherd 400 W. Duarte Rd. Arcadia 91007. 9:00 AM

For more information, visit our Website:http://www.santaanitaas.org