Midwest Fieros Car Club Membership Application

Print this page and mail to address listed below.

Name_____________________________

Address___________________________

City ____________________State _____

Zip _________   Phone ______________

E-Mail ____________________________

Fiero Year_____________

Model ________________

Ext. Color _____________

Int. Color______________

Transmission____________

 

Please fill out and return to Midwest Fieros. The annual fee is $10.00 which will help cover club  expenses. Your membership card will be sent to you upon receiving your application.

 Please send this application and your dues to:  Jerry Burrow, 13601 S. 20th St, Bellevue Ne 68123-4737

President, Dick Edzards: 402-496-2610    e-mail: Richard_Edzards@msn.com

Treasurer & Scribe, Jerry Burrow: 402-291-1334, E-Mail: 2Mules@Cox.net

 

Web Site:  http://www.midwestfieros.org

 


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