New Member _____ Renewal______ Former Member #_______AMO #__________
Name:____________________________________ Spouse: ___________________
Address: _________________________________________ Apt.#______________
City:________________________________________________________________
State/Prov/Parish:__________________________________ ZIP_______________
Phone & Area Code ___________________________________________________
E-Mail: (optional)_____________________________________________________
Other National or Regional AMC Affiliation if any:__________________________
|
Year |
Model |
Engine |
Transmission |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Dues are U.S.Members $ 35.00 per year, Canada & Mexico Members $40 U.S. per year, Overseas Members $45.00 U.S. per year, Vendors/Business $100.00 U.S. per year Please Send a check or money order to: American Motors Owners Association, and mail it with this form to:
American Motors Owners Association Inc.
c/o Don P. Loper
1615 Purvis Ave.
Janesville, WI 53548