SOUTHERN NEVADA AMC CLUB

Date___________________

Name________________________________________

Spouse___________________

Address________________________________________________________________

City_______________________________________

State_____________Zip_________

Phone No._________________________________

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E-Mail__________________________________________________________________

Car(s) Owned:

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Do you belong to any other clubs? Yes____No____.

If yes, which clubs?___________ ______________________________________________________________________

Dues are $15 per year. Please make check or money order payable to SNAMC and send to:

Southern Nevada AMC Club
c/o Mark Ogulnick
1323 Aspen Drive
Boulder City, NV 89005

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