MEMBERSHIP APPLICATION
Bowling Green Speedway
Preservation Society, Inc.
IMPORTANT: This document must be printed out and sent via US Mail
Name: ______________________________________________________________________
Address: ___________________________________________
___________________________________________
___________________________________________
Phone: (______) ______-_____________
Check Applicable Boxes:
(
) New Membership
(
) Renewal
(
) Individual ($10.00)
(
) Family ($12.00)
Additional Applicants for Family Membership:
________________________________________
________________________________________
________________________________________
________________________________________
Family plan covers immediate family members
under 18 years of age.
Make checks payable to B.G.S.P.S., Inc and mail to:
Kathy Heisler
27 Cottage Avenue
Glen Rock, PA 17327
(410) 336-9365 cell