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So, you're ready to become one of us. The process is really simple, and only takes a couple minutes to do. But first, we should take a minute and explain to you some of the benefits that come with being a member of Lake Effect.
An annual membership fee of only $15.00 in the Lake Effect Miata Club will get you:
Now that you know what comes with being a member, simply print, and fill out the form below and send it to the address listed. Until the webmaster figures out how to better set up the forms for printing, you will have to 'copy' and 'print' them the hard way. Sorry for the inconvenience. ANNUAL DUES ARE $15.00 PER CAR. FROM MARCH 1 TO MARCH 1 OF THE FOLLOWING YEAR. PLEASE MAKE CHECKS PAYABLE TO: |
LAKE EFFECT MIATA CLUB
C/O Conrad M. Serwatka
177 East 750 North
Valparaiso, INDIANA 46383
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TODAY'S DATE ____________________________________
MEMBER NAME: ____________________________________________________________________
CO-MEMBER NAME: _______________________________________________________________
ADDRESS: _________________________________________________________________________
CITY: _____________________________________________________________________________
STATE: _________________ ZIPCODE: _______________ HOME PHONE: _________________
WORK PHONE: _____________________ CELLULAR: ___________________________________
E-MAIL ADDRESS: _________________________________________________________________
BIRTHDAY (mo/day) YOURS: ________________________ SPOUSES: ___________________
WEDDING ANNIVERSARY: _________________________ CHILDREN: ____________________
NAMES & AGES: ___________________________________________________________________
YOUR OCCUPATION: ______________________________________________________________
SPOUSE OCCUPATION: ____________________________________________________________
MIATA INFORMATION
YEAR: _______ COLOR: ____________ LICENSE PLATE #: _________________________________
WHAT INTERESTS YOU ABOUT JOINING THIS CLUB? (CIRCLE ALL THAT APPLY)
SOCIALIZING AUTOCROSS TOURING ACCESSORIES DISCOUNTS NATIONAL RALLIES
COMMENTS: ________________________________________________________________________
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If you have any questions or comments, please contact any of the officers or the webmaster
