CENTRAL COAST MODEL T CLUB
OF AMERICA
MEMBERSHIP APPLICATION
P. O. Box 1117
Templeton, CA 93465
www.squeakyspoke.com
PLEASE PRINT
Date______________________ Renew___ New___
Name______________________________________
Spouse’s Name______________________________
Address______________________________________________________________
City_______________________________State________Zip Code_______________
Home Phone__________________________Cell Phone________________________
Email Address_________________________________________
Cars__________________________________________________________________
I would like to receive the Squeaky Spoke Newsletter by Mail____ E-Mail____ (Check one)
Annual dues $20.00 Please remit payment so we can accurately report our club
membership to MTFCA.
Download and mail this form to:
Central Coast Model T FORD Club
P. O. Box 1117
Templeton, CA 93465
Important statement: (This information needed for club insurance eligibility.)
I do___ I do not___ belong to the Model T FORD Club of America (MTFCA)
MTFCA Membership Number______________________
Model T Ford Club of America
Annual Membership Dues are $40.00
(Encouraged but not mandatory at this time)
To get membership form you can go to https://www.mtfca.com/join-or-renew/