MEMBERSHIP APPLICATION
(Just print this page, fill it in, and send it off.)

Name:_____________________________________________________________________


Address:________________________________ Town:______________________________

State (and Country):_________________________________ Zip Code:________________

Telephone:____________________________ E-Mail:_______________________________

Car(s):

Year:____________ Model:________________________ Color:______________________

Serial Number:___________________________________

Year:____________ Model:________________________ Color:______________________

Serial Number:___________________________________

Year:____________ Model:________________________ Color:______________________

Serial Number:___________________________________

Year:____________ Model:________________________ Color:______________________

Serial Number:___________________________________

(Include a photo(s), if you would like, so we can post it on the web.)

What are your interests, concerns, questions or topics concerning your DAF?

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________
Send To:
DAF Club of America
c/o John deBruin
46 Mt. Tabor Ave.
Mount Tabor, VT 05739 USA


E-Mail: thebear5454@gmail.com