| YEAR ________ INDIANA
TRUCK PULLERS ASSOCIATION MEMBERSHIP APPLICATION |
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| ITPA #
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NEW MEMBER |
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YES |
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NO |
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2 WD PRO |
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2 WD MODIFIED |
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4 WD SUPER |
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4 WD PRO |
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4 WD DIESEL |
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_______________
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____________________
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First
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MI
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Last
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City:
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_____________________
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| Print
Phone # in directory? |
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YES |
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NO |
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| E-mail:
________________________________________ |
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ANNOUNCER INFORMATION
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(PRINT OR TYPE LEGIBLY)
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| TRUCK
NAME: _____________________ |
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ENGINE
SIZE: __________ |
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| TRUCK
MAKE: _____________________ |
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YEAR: __________ |
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| ACCOMPLISHMENTS-SPONSORS-SPECIAL THANKS ETC:
________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________ |
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| AGREEMENT |
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As a member of
the Indiana Truck Pullers Association, hereinafter referred to
as I.T.P.A., I agree to abide by all
rules of I.T.P.A. set forth in the current year rule book and to
adhere to the decisions of the tech officials at all
times. If a
legitimate complaint occurs, I will follow the steps outlined in
the protest procedure to settle the matter.
I also agree not to enter into any litigation against
I.T.P.A., it's officers, Board of Directors or Tech Officials.
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Signature:
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________________________
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SS #:
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_________________
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(for tax
purposes)
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INFORMATION BELOW TO BE FILLED OUT BY SECRETARY ↓↓↓ |
| $ ADVERTISEMENTS SOLD:
______________ |
| $ Cash / Check: ______________
Membership Fee: ____________ |
| Date: ______________
Received by Secretary: ________________________________ |
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