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Iroquois Region,AACA, Inc. A regional affiliate of the Antique Automobile Club of America Centrally located in the Binghamton, New York Area APPLICATION FOR MEMBERSHIP PLEASE PRINT
Name: _____________________________________________________ Address: _____________________________________________________ City: __________________________, State: _________ Zip: _______
Telephone: _______________________ E-Mail:__________________________ Date of Birth: ____________________
Spouse Name: __________________________________________________
Make and year of Antique or Classic Automobile(s): (It is not necessary to own an Automobile to be a member.)
Special Interests:
AACA Membership Number:_____________________________ Current AACA membership is a requirement for membership in the Iroquois Region. (AACA Membership applications are available upon request.) or AACA Membership Information and Application Applicant’s Signature: _________________________________________ Annual individual membership dues: $5.00 Annual Joint Membership Dues: $6.00 Dues must accompany application, Make checks payable to: Iroquois Region, AACA
Date Accepted for Membership:
Mail Application to: Steve Boettger 3944 State Route 38B Newark Valley, NY 13811
For more information: E-mail to sboettger@stny.rr.com
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