THE MICROCAR & MINICAR CLUB


                  MEMBERSHIP APPLICATION

If you would like to join the Microcar & Minicar Club
please fill out this form and include it with a check for
$25.00 for U.S. membership ($35.00 in Postal Money order
in U.S. funds for overseas membership) made out to the
Microcar & Minicar Club.

Mail to

The Microcar & Minicar Club
P.O. Box 43137
Upper Montclair, NJ 07042-0137

Name  ____________________________________________

Address  _________________________________________

City/State/Zip/Country____________________________

Phone  (_____) ___________________________________

Email  ___________________________________________

Car Owned

Year ____________  Make________________  Model___________

Body Type  ______________________________________________

Chassis # ___________________  Body # ___________________

Engine #  ___________________  Color  ___________________

Condition  ______________________________________________

For Additional cars please attach additional pages.