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West Coast Vintage Racers Membership Application

Date:________

Name:________________________________________________________

Spouse Name: _________________________________________________

Address: _____________________________________________________

City:_____________________State:_____________Zip Code:_________

Home Phone:____________________ Cell phone:___________________

Birthdate: _________

Email: ____________________________________________

Car Profile:

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Personal Profile:

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It is not necessary of own a car to become a member.
The only membership requirement is an interest in vintage race cars and racing.

Mail along with the $35.00 yearly dues to:

WCVR

PMB 421

4326 SE Woodstock Blvd.

Portland, OR 97206