TIDEWATER TRIUMPH REGISTER
MEMBERSHIP APPLICATION
PLEASE PRINT
NAME:
________________________________________________________________
SPOUSE/COMPANION:
___________________________________________________
ADDRESS: _____________________________________________________________
CITY:_______________________________STATE:_________ZIP
CODE ___________
RESIDENCE TELEPHONE (_______) __________-______________
E-MAIL ADDRESS:_____________________________________________________
ANNUAL DUES: $ 25.00
Make checks payable to:
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Mail to:
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Tidewater Triumph
Register
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BRUCE JORDAN
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TTR MEMBERSHIP
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901 MELODY COURT
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VIRGINIA BEACH, VA.
23464
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CAR REGISTRATION:
Year Model Commission # Condition (see code)
Auto
1___________________________________________________________________
Auto 2___________________________________________________________________
Auto 3___________________________________________________________________
Condition codes: O=original R=Restored RB=Restoration
begun P=Parts Car DD=Daily Driver
Special Interests: (check your interests)
| Car Show | Restoration | Driving/Touring | |||
| Administration | Auto Cross | Mechanical
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To Join the National Organization Please fill out this section and mail it in.
THE VINTAGE TRIUMPH REGISTER
Dues: $25.00 per
year If a member, supply VTR membership number _________
Send to: VTR Membership, PO Box 655, Howell, MI 48844-0655
NAME _____________________________________________SPOUSE__________________________
STREET
ADDRESS____________________________________________TEL: ___________________
CITY:
_________________________________________STATE ______ ZIP______________________
TRIUMPH AUTOMOBILES OWNED
YEAR________
MODEL____________COMM.NO._______________________CONDITION_______
YEAR________
MODEL____________COMM.NO._______________________CONDITION_______
CONDITION CODES:
O=original, R=restored, B=being restored, P=parts car