Name:__________________________________________

 

Address:________________________________________

 

City:___________State:____Zip:_______PH:_________

 

Email:__________________________________________

 

By signing this form, you have accepted the terms of the WAPTCC.  One year membership is $10.

 

Sign:______________________

Date:________________

 

PT Cruiser Description

Year:_______Model:___________

Color:_____________

Features, Accessories and Modifications

_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

About you as a Cruiser owner.

Chat names, Favorite Activities, What you like about your Cruiser

_______________________________________________________________________________________________________________________________________________________________________________________

Please contact us for information on where to mail completed applications. You can bring a completed application to any of our activities, or stop in at Walt’s on just about any Saturday night and see us!! Someone will be more than happy to accept your application!

Wichita Area PT Cruiser Club Membership Application

2006-2007

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