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4th Annual VWs Over Memphis
MAIL-IN
PRE-REGISTRATION

Name: _________________________________
Address: _________________________________
City: _________________________________
State: ______     Zip _____
Your Email ID: _________________________________
Home Phone #: (_____) ____ - __________
VW Club Affiliation _________________________________
Distance you will be traveling to show. ______  Miles
VW Vendor:  __$15.00
VW Show Vehicle __$15.00 for first VW. $10 for each additional VW.
- List the VWs you are registering to show -
If more fields are needed, please "pencil in" as needed.
Year: _____     Model: ____________ ($15)
__Stock or   Modified __  Color ____________
Year: _____     Model: ____________ ($10)
__Stock or   Modified __  Color ____________
Year: _____     Model: ____________ ($10)
__Stock or   Modified __  Color ____________
Total amount enclosed: $_________

Make checks payable to:

 Bill Conkel - Mid-South VW Club

Mail to:

Postmarked NLT 10/9/02

Bill Conkel (VoM4)
5676 Antwerp Ave., W.
Bartlett, TN
38135

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