Updated: 01/31/2009

Whips & Wheels Driving Club Membership Application

Membership will run from January 1^st through December 31^st. 

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 30^th 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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