Spaulding Vintage Equipment Club Membership

Applicant's Name:____________________________________
Address:___________________________________________
City:______________________________State:____Zip______
*Phone:______________________________________
Date of Birth of you and your family members. Year is not required.
Anniversaries are also welcome! Name:__________________Month_______Day_____Year______ Name:__________________Month_______Day_____Year______ Name:__________________Month_______Day_____Year______ Name:__________________Month_______Day_____Year______ Name:__________________Month_______Day_____Year______ Anniversary____________________________(*optional)
Please print this off and fill out and mail this application with the $10.00 membership fee to SVEC Treasurer: Susie Brittian,
118 S Plum, Holdenville, Ok 74848