Historical Automobile Society of Canada

[Pages:1]Historical Automobile Society of Canada

Return to: Mari Parkins mariphasc@ I hereby agree to abide by the By-Laws of this Society

Membership Number National Fee Regional Fee Associate Fees Heritage 35 Fee

$40.00

$10.00

$8.00

$8.00

PLEASE READ IMPORTANT RULES AND INSTRUCTIONS BELOW

First Name Last Name Address City Postal Code Home Region Telephone ( )

Spouse's First Name Spouse's Last Name

Assoc. Region(s) Chapter, Group Email Address

Total

Year (See No. 5)

I OWN THE FOLLOWING HISTORICAL AUTOMOBILES

Make (See No. 6)

Model (See No. 7)

Body Style (See No. 8)

Condition (See No. 9)

IMPORTANT RULES AND REGULATIONS

1. All forms must be signed - unsigned forms will be returned. 2. National, Regional Fees are mandatory and Associate, Heritage 35 Fees are optional. 3. Dues are payable DECEMBER 1st. Delinquent DECEMBER 31st. 4. Please make cheque or money order payable to Historical Automobile Society of Canada. 5. Ownership of a car is not a pre-requisite for membership. 6. List only vehicles 20 years and older. Maximum of 10. (Cars, Trucks, Motorcycles only.) 7. Show make only, use full name e.g. Chevrolet, not Chev. or Chevy. 8. Model Code: e.g. T, D300, DT, 45, Chieftain. 9. Describe body style only, e.g. Sedan, Coupe, etc. 10. Please use the following to describe condition:

A ? restored; B ? complete original; C ? under restoration; D ? rough but restorable; E ? Parts car 11. National "Honorary" members must complete and return a membership form yearly (along with their Regional

fee and any other fees) to maintain their Honorary status. Failure to do so will result in the "Honorary" membership being deleted from the Society membership. 12. Any vehicle listed with H.A.S.C. brought to a Society meet, must carry a current Society Inspection Sticker. 13. One membership encompasses the member, his/her spouse as named on this form, and any dependent children to the end of their eighteenth year (i.e. their nineteenth birthday).

Email National Membership Chairman for information: mariphasc@

Signature

Date

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