We are
   the Good Time Cruisers
            of Locust Grove, VA

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Cut & paste it into your test editor then fill out the form, save it, and either:

attach it to or cut and paste it into an email message and send it to us at [email protected]

OR print it out and bring it to one of our club meetings.  

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GOOD TIME CRUISERS CAR CLUB

MEMBERSHIP APPLICATION FORM

Name_____________________ Date of Birth__________(M/Day)

              Spouse’s Name_____________        

　          Address   ___________________________________________

___________________________________________

　          Home Phone_______________ Cell Phone_________________

              Occupation_________________ Work Phone_______________

              email_________________________________

　          Make & Year of Car(s) ___________________________________

　           _____________________________________________________

_____________________________________________________

  _____________________________________________________

             Recommended By _____________________

　         Annual Dues $25 per family

　         Applicant Signature ___________________________

　         Date Accepted ____________ Signed By _____________________

                                                                                   Club President