TREASURE COAST MUSTANGS MEMBERSHIP FORM

DATE______________

The Treasure Coast Mustangs was founded for those who are interested in and have a fondness for the Mustang automobile. It is not necessary to own a Mustang to belong to the club. Treasure Coast Mustang meets on the fourth Thursday of the month. Call one of the members listed below to find out where the meeting will be held. In addition to meetings, the Club also has a monthly activity. This could be a picnic, scavenger hunt, car show, etc. Dues are $20.00 for a single membership or $25.00 for the family membership per year. Included with your paid membership is our monthly newsletter, "HORSIN’ AROUND".

If you are interested in joining and/or would like to find out more, please come to one of our monthly meetings and/or one of our events. Guests are always welcome! Contact any of the following members for information.

Jeff Rivera, President - 201-7738, Rick Schneider - Vice President - 772-215-9378, Shannon Schneider, Secretary - 772-215-9378, Donna Aquilina, Treasurer - 772-878-0409, Board Members - Mike Owens (club founder) 772-287-6944 — Bill Jones (Past President) -772-879-6615, Donna Jones -772-879-6615, Donna Rivera - 772-336-1704, John Lewis - 772-879-4973, Charlyn Walker - 772-221-3465

Applicant’s Name(s): ___________________________________________________________________

Address: ____________________________________________________________________________

City___________________________________________ State_____________ Zip_________________

Phone Home: __________________________________ Cell: _________________________________

E-Mail Address: _______________________________________________________________________

Member’s Birthday (month/day): __________________ Spouse’s Birthday (month/day): ________________

Wedding Anniversary (month/day): _________________________________________________________

Other family member’s names and birthdays: _________________________________________________

Referred by:___________________________________________________________________________

BRING THIS COMPLETED FORM AND YOUR CHECK FOR EITHER & $20.00 OR & $25.00 TO OUR NEXT MEETING, OR MAIL IT TO OUR ADDRESS SHOW ABOVE.

Date Received_________________ Check /Cash/Amt. ________________ By: _____________________

MUSTANG AUTOMOBILE INFORMATION

Owner’s Name: _______________________________________________________________________

Address (If different from that shown on front): _________________________________________________