WAUPACA ROD AND CLASSIC CAR CLUB          

Waupaca Rod & Classic

Car Club

Membership Application

Name:____________________

Address____________________

City:___________ State____ Zip:_______

Date of Birth:__________

E-mail:_________________

Vehicle Information if Applicable:

Year:______

Make:__________

Model:_________

Membership dues are $15.00 a year.

Please make checks or money orders to:

Waupaca Rod & Classic

P.O. Box 486

Waupaca Wi. 54981

Any questions please call:

920-867-2813

        or

715-256-9547