MEMBERSHIP APPLICATION
Bowling Green Speedway
Preservation Society, Inc.

IMPORTANT: This document must be printed out and sent via US Mail

 

Name: ______________________________________________________________________

Address:   ___________________________________________
                  ___________________________________________
                  ___________________________________________

Phone: (______)  ______-_____________

Check Applicable Boxes:

            (  )   New Membership
            (  )   Renewal

            (  )   Individual ($10.00)
            (  )   Family ($12.00)
                    Additional Applicants for Family Membership:
                    ________________________________________
                    ________________________________________
                    ________________________________________
                    ________________________________________
                    Family plan covers immediate family members
                    under 18 years of age.

Make checks payable to B.G.S.P.S., Inc and mail to:
                    Kathy Wilhelm
                    122 W. Cloverdale Ave.
                    Shrewsbury, PA 17361

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