ELCC Membership Application

To join, print and mail this completed form along with a US$25 check made payable to 'Evergreen Lotus Car Club' to the following address:

       Evergreen Lotus Car Club
      
220 West Howe Street
       Seattle, WA 98119, USA

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Name

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Address

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City, State, Zip, (Country)

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Phone Number

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Email Address

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Occupation

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Hobbies

What are your club interests?

TrackAutocrossConcours
ToursRalliesSocial
RestorationTechnicalOther_______________________

Lotus and Other Specialty Vehicles:

YearMakeModelColorVin#