Antique Automobile Club of America

                    Wayne - Pike Region A.A.C.A.

Membership Application

Name_____________________________ Spouse________________

Address__________________________________________________

City , State , Zip___________________________________________

Phone___________________________ Email__________________

Birthday (Not Year)________________________________________

Occupation_______________________________________________

National AACA Membership #________________Letter__________

You have to be a member of the National AACA  

 click here for application

Our Dues are $10.00 , Payable to Wayne-Pike Region A.A.C.A.

Make if Vehicles ( Antique or Classic) list 3-4 vehicles & Include Models , style, year & Color    if you want a picture posted in our gallery of these vehicles send them to ;

Vehicle # 1_______________________________________________

Vehicle # 2_______________________________________________

Vehicle # 3_______________________________________________

Vehicle # 4_______________________________________________

 

DUES MUST ACCOMPANY THIS APPLICATION

Mail to;