Membership Application

 

 
The Porsche 356 Club is a non-profit organization devoted to the preservation of the vintage 356 series Porsche automobile.
One year U.S. membership - $35.00 Canada & Mexico $45.00 U.S. Overseas $55.00 U.S.
Two year U.S. membership - $70.00 Canada & Mexico $90.00 U.S. Overseas $110.00 U.S.

Purchasing multiple years saves the Club on reminder postage and processing.

Membership: New Renewal Change of Address
Member # (for renewals/change of address - see your mailing label)

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
E-mail

356 owned: Yr   Body Style   Model    2+ 356s Looking

Payment $ Check VISA MC AMEX

Card No.
CW2/CVC2/CID #
See location (right)		 Visa #
AMEX #		 Expiration:
/
mm  /  yy

Signature

You can type the information into the form above, print it out, and mail or fax to: 
 
Gary Dunavan
4865 Via del Corral
Yorba Linda, CA 92887
dunavang@prodigy.net

Phone (714)777-8052

Please Make Checks Payable to: Porsche 356 Club - U.S. Funds Only

 

Thank You for your support!!