Whips & Wheels Driving Club Membership Application
Membership
will run from January 1st through December 31st.
Family
Membership 2 or more people up to 4, (voting privileges 18 years or older).
Single Membership 1 person only, $15.00
NEW
Memberships joining AFTER June 30th will be prorated at
$12.00 (Family)
$7.50
(Single) for the remainder of the year
New or renewing current
memberships after November 1st are good for the following year.
Dues are due the first of January each
year.
Please
print out form below & fill out then:
Make Checks payable to: Whips & Wheels Driving Club or WWDC
Mail form & check to: Pat Granzyk 6988
Lanvale Ct. Clemmons, NC 27012
___ Family Membership full year $25.00 (Family
Membership 2 or more people up to 4)
___ Single Membership full year $15.00 (1 person)
___ New After June 30th 1/2 year $12.00 Family
$7.50 Single (remainder of the year.)
___ New & Renewing Memberships AFTER November 1st run through
the following year.
Total $ Enclosed $ _____________
Please provide the following contact
information For our Membership/Business directory
First
Name: ______________________________________________________
Last
Name: ______________________________________________________
Farm
Name: ______________________________________________________
Address:
_________________________________________________________
City:
____________________________ State: _______
Zip: _____________
Home
Phone: _____________________________________________________
E-Mail:
___________________________________________________________
Business: _______________________ Web Site: ________________________
Work or
Cell Phone: ________________________________________________
Description:
_______________________________________________________
Date
Received: _________________________ (Office Use)
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