Pro Nostalgia Association
Membership Application

Owner ___________________________________

Address __________________________________

City _____________________________________

State & ZIP ______________________________

Phone ___________________________________

Email ___________________________________

Driver ___________________________________

Comp. License # __________________________

Car Name ________________________________

Car Number ______________________________

Body Type & Year _________________________

Engine Make & Size ________________________

Special Features (ie. blown, injected, etc.):

_________________________________________

Best ET __________________________________

Best MPH ________________________________

Sponsors _________________________________

_________________________________________

_________________________________________

Signature _________________________________

Date _____________________________________

Please return this membership application
with annual dues of $100.00 per car and driver.

Make check payable to:

Pro Nostalgia Association
25553 SW Airport Ave.
Corvallis, OR 97333