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Click here for an application that can be printed out

Inland Empire GTO Club Membership Application

Name: ____________________________________________________ Today’s Date________________

Spouse’s or Significant Other’s name: ____________________________________________________

Street Address: ________________________________________________________________________

City: _____________________________________________ State: _____________ Zip: ______________

Home Phone: ____________________Cell: _______________________ Work: ____________________

Email Address__________________________________________________________________________

Birthday: ________________ Spouse’s Birthday: _________________ Anniversary________________

Vehicles:

Year: ___________Make: ____________________________Model: ______________________________

Year: ___________ Make: ____________________________ Model: _____________________________

Year: ___________ Make: ____________________________ Model: _____________________________

Year: ___________ Make: ____________________________ Model: _____________________________

T-shirt Size:        |_| Small        |_| Medium         |_| Large         |_| 2X         |_| 3X         |_| 4X         |_| 5X

This information is requested for club use only. We do publish a roster on our website and like to include all members.  Please indicate if your information can be published with the others:
                     |_| Publish telephone number and email address with other member’s information
                     |_| Publish only Names.

New members must submit an application for membership to the club treasurer. Membership is reserved to those individuals who have an avid interest in Pontiac’s, agree to abide by the bylaws of the club, and agree to conduct themselves in accordance with the family oriented nature of the club. New members must submit with their application the annual club dues of $20.00 which also includes the immediate family of member. Please print and complete this application.  Mail the completed application to:

Inland Empire GTO Club
New Member Application
c/o Tim Rankin

P.O. Box 9631
Redlands, CA 92375