Membership Application Name:   Address: Postal Code:                                     Phone Number: E-mail Address: Referred to Association by: Mustang(s) Presently Owned 1. 2. Primary interests (check all that apply)   Restoration   Parts   Location   Social Activities   Parts Discounts   Car Shows   Camping   Displays   Newsletter Articles Other: Fee Structure   New Membership Start-up Fee:   $5.00    Yearly Membership January to December:  $25.00   Additional Family Membership:   $10.00       ** All memberships terminate December 31 of the year joined ** Amount Submitted: $ Date: Signature: Send Payment to: Vancouver Island Mustangs Association PO Box 24056 4420 West Saanich Rd Victoria, BC   V8Z 7E7

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