
Model
T Ford Club of Central Florida, Inc.
Application for Membership
Date of Application:_______________________
Name:________________________________ Spouses Name:_____________________
Address:_____________________________ City:____________________ State:_____
Zipcode:__________ Home Telephone:_______________ Alt. Phone:_______________
Using Email saves your club at least $4.68 per club member. Would you like your newsletter via Email ___or Mail ___ Email Address:____________________________
Are you a current member of the Model T Ford Club International?
Yes ___ No ___ Membership Number: ___________________________
Are you a current member of the Model T Ford Club of America?
Yes ___ No ___ Membership Number ___________________________
Would you be willing to serve the club as ( ) Club President ( ) Club Vice-President ( ) Club Treasurer ( ) Club Secretary ( ) Touring Committee ( ) Planning Committee ( ) Social Committee ( ) Telephone Committee ( ) Awards Committee ( ) Newsletter Editor ( ) Email Coordinator ( ) Tinkering Tips ( ) Birthdays/Anniversaries
( ) Hosting a Tour ( ) Hosting an Event ( ) Hosting a Workshop ( ) Picnics and Parties ( ) Mechanical Advisor ( ) Name Tags, shirts, and hats ( ) Public Affairs
What suggestions do you have for the club to provide more interesting activities and events for you as a club member to get more involved and have more fun?
________________________________________________________________________
________________________________________________________________________
Please list the year and body style of your Model T’s:
________________________________________________________________________________________________________
The annual membership dues for our club are $10.00 per year non-pro-rated. All memberships expire on December 31st. Prompt renewal of your membership will ensure inclusion in the annual membership directory which will be published March 1st. Membership dues can either be brought to a meeting or mailed care of our treasurer Wanda Johnson at 1173 Palos Verde Dr. Orlando, FL 32825. To tour with our club membership in the MTFCI is mandatory for insurance reasons.