--------------------The 30th T/A Organization Membership Form--------------------

Mail to: 
Steven Brown
1502 W. Thompson Ave.
Enid, OK 73703-7851

30th T/A Organization Member $20.00 / year  (NON-PROFIT)(Please Make Check Payable to Steven Brown)
**Money Goes to Pay For the Website, Forum/Msg board, Club Decals, and Business Cards**
Please feel free to include any info about your car, stories, mods, or some pics for the webpage!

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The Membership Includes:
-Official Member Number 
-Some Official 30th T/A Organization Business Cards (~15) 
-One Official 30th T/A Organization Club Window Decal 
-Official Member Photo Card 4x6 
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Membership Information: 
Last Name___________________________________ First Name________________________

Street Address_________________________________________________ Apt. #_________

City________________________________ State____________________ Zip_____________

Phone(home,work,cell) _______________________________________________(optional)

Email Addresses _______________________________________________________________
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30th T/A Information: (please check or fill in all that apply)

Year _1999__ Model __Firebird-Trans Am________Coupe _______ Convertible _______

Vin# __________________________________________________ Car# __________________

If an official Daytona 500 Parade Lap Car please include the D.A.# ____________

If an official Daytona 500 Pace Car please include the P.C.# __________________

Transmission _______ Hurst Shifter (if M6) __________ Traction Control ________

Moonsoon CD _________________ 12 Disc CD ____________ Tape Player _____________
 

Do Not Write Below This Line

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Business Card______ Window Sticker______ Membership Date___________