MEMBERSHIP
FORM
FORM
| ANNUAL MEMBERSHIP $10.00 (each additional immediate family membership $5.00) All memberships begin/end the first of June each year to coincide with our annual National Championship event. Full Membership package includes: HOPRA Membership Card (good for discounts), 2 HOPRA logo stickers and any National HOPRA mailings. |
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NAME: ______________________________________________________________________
ADDRESS: ___________________________________________________________________
CITY: ____________________________ STATE: ______________ ZIP : _________________
PHONE: ______________________________EMAIL: _________________________________
STATE/REGIONAL GROUP: _____________________________________________________
LOCAL RACING GROUP: _______________________________________________________
NEW MEMBERSHIP: _______ FAMILY MEMBERSHIP: ______
RENEWAL: ______ MEMBERSHIP #: ____________________
ADDRESS: ___________________________________________________________________
CITY: ____________________________ STATE: ______________ ZIP : _________________
PHONE: ______________________________EMAIL: _________________________________
STATE/REGIONAL GROUP: _____________________________________________________
LOCAL RACING GROUP: _______________________________________________________
NEW MEMBERSHIP: _______ FAMILY MEMBERSHIP: ______
RENEWAL: ______ MEMBERSHIP #: ____________________
| All information is for HOPRA use only All proceeds from memberships go to support Annual HOPRA National Championships |
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(FOR HOPRA USE ONLY)
PAID: ______ RECV. BY: ________________________ EXP. DATE: _________________
MEMBERSHIP PKG. SENT: ______ MEMBERSHIP #: ___________
DRIVER CLASSIFICATION: AMATEUR: ______ PRO: ______
PAID: ______ RECV. BY: ________________________ EXP. DATE: _________________
MEMBERSHIP PKG. SENT: ______ MEMBERSHIP #: ___________
DRIVER CLASSIFICATION: AMATEUR: ______ PRO: ______
| PRINT, FILL OUT & MAIL WITH A CHECK OR MONEY ORDER PAYABLE TO: Dave Lehr 4935 Arabian Run Indianapolis, IN 46228 |
