The club provides its members with the opportunity to talk about, help with, organize and compete in an array of motor sports activities. If you would like information about joining the club, call Jim Cooper, our membership Secretary, at 717 652-4316.

Click here for
Printable New Member Application (Adobe PDF)

or
Current Member Renewal for 2007 (Adobe PDF)

Membership Application

Appalachian Sports Car Club

Mail To: Jim Cooper, Membership Secretary
6021 Cherry Hill Road, Harrisburg, PA 17111
ASCC
Single Membership - $12 Family Membership* - $17
*Family membership includes children living at home up thru age 21.  
Name Date of Birth
Spouse Date of Birth
Address
City State Zip
Phone(Home) (Work)
Email Address:
Your Employer/Occupation
Spouse's Employer/Occupation
Education:
High School:_____ College:____

Other______________ Degree__________

Special Training or Skills:

_______________________________________

Hobbies:

_______________________________________

_______________________________________

Specify Major Sports Car Interests:

_______________________________________

_______________________________________

_______________________________________

_______________________________________

Car(s) now owned:
_______________________________________

_______________________________________

Sports car(s) previously owned:
_______________________________________

_______________________________________


















Would you be willing to work on committees?
Yes:_____ No:_____

Specify the names of other sports car clubs in which you previously or now hold membership:

SCCA

Other:__________________________________

Offices Held:_____________________________

Licenses Held:____________________________



Signature________________________________

Date ___________________________________









For quickest return, send S.A.S.E.
FOR OFFICIAL USE
Date application received in membership committee____________________

Fee paid______________________

Approved by___________________

Date___________________






page last updated: 12/20/06