Coastwatchers Application

MS COAST WATCHERS MEMBER APPLICATION

COASTWATCHERS.ORG

AFFILIATED WITH THE MILITARY VEHICLES PRESERVATION ASSOCIATION

Print, Fill out and Mail In.

NAME……………………………………………….DATE…………

 

SPOUSE…………………………………………….

 

ADDRESS………………………………………………………………….

 

E-MAIL………………………………………………………………………

 

PHONE (     )…………………..CELL (     )………………………

 

MVPA MEMBER  YES  NO    MEMBER NUMBER……………

MEMBER OF SIMILAR CLUBS…………………………………

 

RECRUITER………………………………………………………………

 

VEHICLES OWNED…………………………………………………..

 

CIRCLE YOUR INTEREST      RESTORATION    DISPLAYS    CONVOYS

CAMPING    PARADES   TRAIL RIDES   OTHER

 

FAMILY MEMBERSHIP DUES    $20.00      DUE IN MAY ANNUALLY

EACH NEW MEMBER WILL RECEIVE A    T-SHIRT AND  PATCH  AND  NEWS LETTER

 

EXTRA SHIRTS CAN BE PURCHASED  $15.00 TO XL   $16.00 FOR LARGER  $3.OO PATCH

 

MAKE ALL CHECKS PAYABLE TO    MS COAST WATCHERS

 

MAIL TO……….

GEORGE CASEY

903 MARJORIE ST

LONG BEACH MS  39560