CLASSIC THUNDERBIRD CLUB OF WISCONSIN

         Membership Application

NAME: _______________________________ Birthday __________
           (first, last)                                                       (Month & Day only)
SPOUSE: ______________________________ Birthday _________
              (first, last if different)                          (Month & Day only)
ADDRESS: _________________________________
CITY________________STATE_____ ZIP_________ (9 digit, if known)
E-mail_________________________

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

Home phone     (       ) _______________ Unlisted? Yes____ No____
Business phone (       ) __________________ Fax (       )___________
Cell phone (      ) _____________________

           CAR INFORMATION
                                                     Body            Exterior
      Year            Body Style           Color             Color                Serial No.
_____________ _____________ _____________ _____________ _______________
_____________ _____________ _____________ _____________ _______________
_____________ _____________ _____________ _____________ _______________
                                
                                      (Please enter additional cars on a separate sheet)
If you have a Wisconsin Collector Plate number what is it ? ___________

Amount enclosed $__________ see below for dues schedule
                           
                                 Mail application to:
                     Jim Morris - Membership Chairman
                               866 South 75th Street
                           West Allis, WI 532 14-3013
                   membership@wisconsin-thunderbirds . org

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)

MEMBER BUSINESS PROFILE:
If you either own or work for a business that you would like the members to be aware of, please provide that information here. We occasionally include this information in newsletter articles.
______________________________________________________________________________
______________________________________________________________________________ _____________________________________________________________________________
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INSURANCE NOTE:
Members are required to carry liability insurance meeting the current Wisconsin minimums on any vehicle that is used during a club event.

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 :                                                                Pro-rated dues schedule
JIM MORRIS (MEMBERSHIP)               Jul.-$36.00     Aug.-$33.50      Sept.-$31.00
866 South 75th STREET                            Oct.-$28.50     Nov.-$26.00      Dec -$23.50
WEST ALLIS WI 53214-3013                   Jan.-$21.00      Feb.-$18.50      Mar. -$16.00
                                                                   Apr.-$43.50      May.-$41.00     June.-$38.50