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Membership/Renewal Form

Name _______________________________________Birthday (mm/dd)____________

Associate Member / Spouse__________________________________________________

Address ________________________________________________Apt #____________

City/ST/Zip_____________________________________________________________

Telephone____________________________________ Include in roster?____________

Email ______________________________________________________

GTOAA Membership #________________________________________

Please list all GTOs owned

Year Style Engine Drive Train

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

Are you willing to help others with their GTO's?__________

Personal help?____________Tools?_________Parts?__________Info?_____________

Remarks ____________________________________________________________

____________________________________________________________

Referred by ____________________________________________________________

Annual Dues are $25.00 (see below chart for prorated dues) ____________

If GTOAA member dues are $20.00 (see below chart for prorated dues) ____________

Special “new” GTOAA membership with SCGG renewal, $40.00 ____________

GTOAA is $30 annually. ____________

Please mail completed Membership Application with your dues payment to:

SCGG Membership

1015 Lynwood Drive

Brea, California 92821

	May	Jun	Jul	Aug	Sep	Oct	Nov	Dec	Jan	Feb	Mar	Apr
SCGG	$25.00	$22.92	$20.83	$18.75	$16.67	$14.58	$12.50	$10.42	$8.33	$6.25	$4.17	$2.08