Michigan Widetrackers
Chapter 16 of Pontiac Oakland Club International
Membership Application
_____________________________________________________________________________________Benefits of Membership: Local, National, & International contacts.
POCI monthly magazine - Smoke Signals. Free monthly advertising in Smoke Signals. Tracker newsletter printed bi-monthly. Monthly meetings and activities. _____________________________________________________________________________________Today's Date:________________________
Primary Member:___________________________________Birth Date:_____________
Spouse or Associate Member: _________________________Birth Date:____________
Address: ____________________________________________________
City, State and Zip:____________________________________________
Telephone:_____________________ Email:________________________
POCI #: _________________ Signature:________________________________________
(MUST BE A CURRENT MEMBER OF POCI TO JOIN WIDETRACKERS.)Children: _______________________________________Birth Date________________
_______________________________________Birth Date________________
Classic or Collector Cars: Year, Make, Model, Color, # of Cylinders
______________________________________________________________________________
______________________________________________________________________________
Annual membership dues for WIDETRACKERS is $18.00. Dues are to be paid each May.
If joining for the first time, dues will be pro-rated at $1.50 per month. Please pay by cash or check made out to: MICHIGAN WIDETRACKERS
Return this application and dues to: WIDETRACKERS MICHIGAN CHAPTER 16 OF POCI
c/o Mike Woody 6057 Washburn Road Goodrich, MI 48438
Contact Mike Woody for a National Application if needed.
Office Use: local # ______ Year: _____ _____ _____ _____ _____ _____ _____