Membership Application

Membership type desired:*Reg____*Asoc.____*Asoc.Com._____

Name:__________________________________ Date: ________________

Spouses Name:___________________________ TLCA #______________

Mailing Address:_______________________________________________

City:_____________________________ State:______ Zip:_____________

Home Ph.: (____) _____-___________ Work Ph.: (____) _____-________

CB Handle:__________________________ HAM Call Sign:___________

Vehicle: 19____, _____________________ Model:___________________

How did you find out about Colorado Land Cruisers?__________________

_____________________________________________________________

If applicable:

Fax: (_____) _____-____________ Email Address:___________________

*Regular, Voting Membership; you must meet the following requirements:

1.Be the Owner of a Toyota 4WD vehicle with a low-range.

2.Be a legally licensed driver at least 18 years of age.

3.Must show proof of membership in, or join, Toyota Land Cruiser Association.

4.Must show proof of adequate liability insurance and legal registration.

5.Bring completed application to the next monthly meeting.

6.Dues:CLC=$20.00/year.

*Associate Membership:

1.Be a legally licensed driver at least 18 years of age.

2.Must show proof of adequate liability insurance and legal registration.

3.Bring completed application to the next monthly meeting.

4.Dues: CLC=$20.00/1st year/$10.00 thereafter.(non-voting member)

*Associate Commercial Membership:

1.Bring/Send application to the next monthly meeting.

2.Dues: $40.00/year = Associate Member List in News Letter(non-voting member)

Please fill out this application and bring it to our next Club meeting.

Feel free to e-mail David, our Membership Chairperson at Membership@ColoradoLandCruisier.org or Kendall, our CLC club President, President@ColoradoLandCruisers.org for more information.

TLCA dues are $25/yr and the responsibility of the individual Regular Member.