Name of primary member:  

Name of second family member:  

List children who will be members.
                    

Mailing address:  
                             TNNCKYGAVAWrite state in box with city.

Telephone number(s):  -HomeWork
Telephone number(s):  -HomeWork

E-mail address:  @
Second e-mail address:  @

Web site (if any):  

Old car number 1 (year make model type):  
Old car number 2 (year make model type):  
Old car number 3 (year make model type):  
Old car number 4 (year make model type):  

Studebaker Drivers Club membership number:  
Expiration date:  
If not yet an SDC member, I have applied for membership.


This button resets everything back to the default values.  

Dues are $10 per year for a family membership, and the membership year is January through December. Print this page and send it along with a check made to "Smoky Mountain SDC" to:

         Joe Inman
         228 Marquiss Circle
         Clinton, TN 37716-6061