Name: ________________________________________
Spouse: _______________________________________
Address: ______________________________________
City: __________________________________________
State: ___________
Zip: ___________
Telephone #: ___________________________________
Date of Birth: ___________
MCA #(not required): _____________________________
Types of Mustangs Owned: ________________________
Year and Models: (Ownership not required) _______________________________________________
Applicant's Signature:_____________________________
Date:_____________

Dues are $ 25.00 for inital year,this includes adhesive decal,static-cling decal and monthly issues of Pony X-press,the TPM&FC newsletter. Renewal dues are $ 20.00 for non MCA members and $ 15.00 for MCA members.
Dues must accompany application form. Make checks payable to Twin Ports Mustang and Ford Club and mail to:

Twin Ports Mustang and Ford Club
PO Box 16436
Duluth,MN 55808