Online Application - Membership for Cars of Palestine

If the form below doesn’t have enough room for the number of family members and/or autos that you have, please provide that information as soon as you are able to the Secretary. You may either provide that information by email to clandrum4615@gmail.com or in writing to the Secretary at the next meeting or to Cars of Palestine; P.O. Box 2112; Palestine, Texas 75802-2112.


The annual membership fee is $25 per family, due each January. You may pay online through PayPal (a fee of 58¢ will be charged at time of payment) you will find a link after you submit your application, or pay by cash or check made out to Cars of Palestine and give it to the Secretary in person or by mail.

First Name (required)

Last Name (required)

Email

Address 1 (required)

Address 2

City (required)

State

Phone Number - Home (required)

Application Date

Phone Number - Cell

Applicant’s Place of Employment

Phone Number - Work

Applicant’s Birth Date

Spouse's Name (First Name Only)

Spouse - Cell

Spouse’s Email

Spouse’s Birth Date

Wedding Anniversary

Spouse’s Place of Employment

Spouse’s Phone Number - Work

Car Information

Number of Special Interest Autos Owned

Auto 1 - Make

Auto 1 - Model

Auto 1 - Year

Auto 1 - Body Style

Auto 1 - Special Notes

Auto 2 - Make

Auto 2 - Model

Auto 2 - Year

Auto 2 - Body Style

Auto 2 - Special Notes

Club Activities/Offices You Would Like to be Involved In?

Name of member who encouraged you to join?