Page 1. CINCY CUSTOM STREET. MACHINES CAR CLUB. Membership Form.
Name: Address: Home Phone: Cell Phone: Birthday: Family Member ...
CINCY CUSTOM STREET MACHINES CAR CLUB Membership Form Name: ______________________________________________ Address:_____________________________________________ ____________________________________________ Home Phone: ________________ Cell Phone: _______________ Birthday:_______________ Family Member Names: __________________________________________________ __________________________________________________ __________________________________________________ __________________________________________________ __________________________________________________ Car Information: __________________________________________________ __________________________________________________ __________________________________________________ Annual Dues $30.00 Make checks payable to Cincy Custom Street Machines Mail to Ken Renner 5338 Teaberry Lane Cincinnati, Ohio 45238
