The 30th T/A Organization Form

The 30th T/A Organization Membership Form
(Mail to: Steven Brown/2040 Vanamen Ct./Conroe, TX 77304-1601)

30th T/A Org. Member $20.00 / year (NON-PROFIT)(Please Make Check Payable to Steven Brown)
**Money Goes to Pay For the Website, Forum/Msg board, Club Decals, and Business Cards**
Please feel free to include any info about your car, stories, mods, or some pics for the webpage!

The Membership Includes:
  1. Official Member Number
  2. Some Official 30th T/A Organization Business Cards (~15)
  3. One Official 30th T/A Organization Club Window Decal
  4. Official Member Photo Card 4x6

Membership Information:

Last Name__________________ First Name____________________

Street Address__________________ Apt. #_________

City_______________ State____________ Zip___________

Phone(home,work,cell) _____________________________(optional)

Email Addresses ________________________________________

30th T/A Information: (please check mark or fill in all that apply)

Year 1999 Model Firebird-Trans Am Coupe ____ Convertible ____

Vin# ___________________________ Car# _______

If an official Daytona 500 Parade Lap Car please include the D.A.# _____

If an official Daytona 500 Pace Car please include the P.C.# _____

Transmission _____ Hurst Shifter (if M6) ___ Traction Control ___

Moonsoon CD _____ 12 Disc CD _____ Tape Player _____

Do Not Write Below This Line

Business Card______ Window Sticker______ Membership Date___________ Assigned Member#_____________