MEMBERSHIP APPLICATION
EAST GRAND PACKARDS
A Region of Packard Automobile Classics, Inc.
Membership* (requires membership in Packard Automobile Classics) $15.00
NAME_______________________________________SPOUSE___________________
ADDRESS______________________________________________________________
CITY___________________________________STATE_______ZIP________________
OCCUPATION (optional)___________________________________________________
HOME PHONE__________________ FAX_____________ BUSINESS_____________
E-MAIL____________________
PACKARDS OWNED
Year Series # of cyl Body Style Condition
1. ______________________________________________________________________
2. ______________________________________________________________________
3. ______________________________________________________________________
4. ______________________________________________________________________
Please use reverse side
if needed for additional Packards or comments.
Are you a member of Packard Automobile Classics ?
____Yes ___No PAC #______
What other auto organizations are you a member of? ______________________________
Will you be willing to serve the club as an officer__________ or on a
committee_________
Member's Signature _____________________________________ Date____________
Return completed form to:
Bart Rasmus,
11 Oakwood Dr.
New Hartford, NY 13413
phone: 315-734-1555
E-mail bartonrasmus@aol.com
Make checks payable to East Grand Packards