2011 Spring Dustoff Registration Form

'2011' Spring Dustoff Car Registration Form

Print Out This Page and Mail To:

LI & NYC OLDS CLUB
527 PECAN STREET
LINDENHURST, NEW YORK 11757


NAME_____________________________   CAR YEAR______________________________


ADDRESS__________________________   MAKE__________________________________


CITY,STATE_________________________ MODEL_________________________________


ZIP CODE__________________________  BODY__________________________________


PHONE (      )________________CLUB AFFILIATION____________________________


            MAKE CHECKS PAYABLE TO:  LI & NYC OLDSMOBILE CLUB
               PRE-REGISTRATION DEADLINE APRIL 18,2011
                          ALL CARS WILL BE CLASSIFIED AT THE GATE

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