Please return this filled application form with the annual fee:
$US 25.00 or $CA 30.00
(Cheques should be made payable to WDMGC)
PayPal available at WDMGC.com

Send form with payment to:

WDMGC Membership
2094 Cliffside Dr.
Wixom, MI 48393
USA


Your membership includes 2 nametags. Please print the names as you wish them to appear on the tags. Additional tags are available for $5.
 

Name____________________________ Companion_________________________

Address_____________________________________________________________

City_______________________________State/Province______________________

Zip/Postal Code_________________

Primary phone_____________________ E-mail____________________________

Mobile Phone____________________(Optional) (Please enter again if same as Primary Phone)

Please list year, model, body style and colour for British cars only:

Car #1: Year _______model____________body style____________colour____________

Car #2: Year _______model____________body style____________colour____________

Car #3: Year _______model____________body style____________colour____________

Car #4: Year _______model____________body style____________colour____________

Car #5: Year _______model____________body style____________colour____________

Car #6: Year _______model____________body style____________colour____________

Car #7: Year _______model____________body style____________colour____________

More than 7 British cars? Please list others on a separate sheet.

Please put a check-mark here if you are a member of NAMGAR [   ] and/or NAMGBR [   ]