Pacific Bantam Austin Club Membership Application

Austin Bantam Society Membership Application

Membership: $20.00 per calendar year; Outside U.S. $25.00 (airmail)

(Ownership of an Austin/Bantam etc. is not a prerequisite)

Name _______________________________________________Spouse’s Name __________________

Address ___________________________________ Phone and/or E-mail ________________________

City _____________________________ State ____ Country __________________Zip ____________

Please make your check payable to AUSTIN BANTAM SOCIETY and return with this form to:

Membership Chairman

Austin Bantam Society

1589 N. Grand Oaks Ave.

Pasadena, CA 91104

Austin(s) and/or Bantam(s) OR Other Club Cars presently owned

Year Body Style Body Number Engine Number Frame Number if any Condition

____________________________________________________________________________________

(When available, please enclose photo(s) of your car(s) for possible use in Rooster Tails)

Remarks of particular interest regarding ABS or the cars. ____________________________________

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