CLASSIC THUNDERBIRD CLUB OF WISCONSIN

         Membership Application

MEMBER: __________________________   Birthday ___________
                   (first, last)                                           (Month & Day only)
SPOUSE/OTHER: ____________________    Birthday ___________
                            (first, last name if different)         (Month & Day only)
ADDRESS: _________________________________

CITY________________STATE_____ ZIP_________ (9 digit, if known)

  
     ( All of the information below is optional and is not made available to non-club members)

Home phone     (       ) _____________ Unlisted? Yes____ No____
Business phone (       ) _____________  Cell phone (      ) ___________
Email ________________    Fax   (       ) _____________

NEWS LETTER DELIVERY
It will be in MS/Word format.If you need it sent to a d ifferent email, you  prefer it to be Postal Mailed to your home, or you would like it in PDF format, please contact the Editor or myself to arrange it.

Winter mailing address ( if different from above ) Address_______________________
City ____________________________ State________ Zip_________ 
Home phone (       ) _____________ Unlisted? Yes____ No____

           CAR INFORMATION
                                                       Body              Exterior
      Year             Body Style           Color                Color                Serial No.
_____________  _____________  _____________  _____________  _______________
_____________  _____________  _____________  _____________  _______________
_____________  _____________  _____________  _____________  _______________
                                 
                                      (Please enter additional cars on a separate sheet)


Do you have a Wisconsin Collector Plate number ? yes________

NOTE:
CTCW highly recommends that you join the national affiliate club for your generation of Thunderbird. If you are not a member of any of these organizations, please ask for a national membership form. If you are a current member, please provide your membership number(s) below .

 CTCI No. ________             VTCI No. ________              ITC No. ________
                     (55-57)                               (55-current)                         (55-current)

INSURANCE NOTE:
Members are required to carry liability insurance meeting the current Wisconsin minimums on any vehicle that is used during a club event

MEMBER  PROFILE:
Tell Us about yourself. Also, if you either own or work for a bussiness that you would like the members to be aware of, please providethat information here. We occasionaly include this information in newsletter articles 
______________________________________________________________________________
______________________________________________________________________________ _____________________________________________________________________________
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DUES:
Dues are $30 per year, new member dues include an initial one-time $6.00 fee. Your initial dues are pro-rated from the month you join, based on renewal in July. Submit your dues per the following schedule:

MAKE CHECKS PAYABLE TO
   "CTCW" AND SEND TO :                                                                                       
JIM MORRIS (MEMBERSHIP)                                                                            
866 South 75th STREET                      
WEST ALLIS WI 53214-3013              
                                                               

Pro-rated dues schedule
( including initial fees)  
Jul- $36.00    Aug- $33.50   Sept- $31.00
Oct- $28.50   Nov- $26.00   Dec- $23.50
Jan- $21.00   Feb- $18.50   Mar- $16.00
 Apr- $43.50    May- $41.00  June- $38.50