Membership

(you can view pdf version by clicking link at bottom of page)

APPLICATION FOR MEMBERSHIP

WESTERN REGIONAL CHAPTER

WOKR

Mail this form to:

Rhonda Rossman

18004 SE 315th ST

Auburn, WA   98092

 Please include $10 for one year dues.  Check payable to "Western Chapter WOKR"

PLEASE PRINT

_____________________________________    _______________________   _______  

First and Last name of applicant                          First name of spouse or joint member     Date

______________________________________________      ______________________     _______________    ______________

Street address                                               City               State or Province    Zip code

_____________________     ______________________    _____________________             _____________________________

Country                                 Telephone            Cell                                      E-Mail

Are you a member of WOKR International?   Yes__ Number______   NO___

How did you learn about our chapter? ______________________________

_______________________________________________________________________

TO BE A MEMBER OF A CHAPTER YOU MUST BELONG TO THE INTERNATIONAL WOKR.  ASK FOR A MEMBERSHIP APPLICATION IF YOU NEED IT.

List your cars: Overlands, Willys-Overland, Willys (up to 1942), Whippet and Knight engine vehicles.

MAKE   YEAR   CYL   MODEL   BODY STYLE   SERIAL NO.  ENG NO.   CONDITION

________  _____    ____     ______    ____________       ____________   __________   ____________

________  _____    ____     ______    ____________       ____________   __________   ____________

________  _____    ____     ______    ____________       ____________   __________   ____________