PSMC Online Application

Member:   Spouse/Significant Other:  
*First Name: Spouse First:
*Last Name: Spouse Last:
 
*Address:
*City:
*State: *Zip:
 
Contact Info: (000-000-0000) Car Info:  
*Home Phone: Year:
Cell Phone: Color:
*Email: License:
 
Preferences (check all that apply)
  Road Tours
  Parades
  Autocross
  Socials
  Tech Seminars
  Driver School
  Local Meetings
  Rallies
  Other
 
  How would you like your newsletter
(The Sounder) delivered to you?
  Email
  Download it
  Snail Mail
 
  Would you like to be listed in the printed roster
(usually published yearly)?
  Yes
  No  

Your membership application can not be completed until your dues ($30 for Email or $40 for Snail Mail)
are received by the Membership Chairperson. Please print a copy of the confimation page to include with your check.
Dues may be mailed to:
Puget Sound Miata Club
c/o Mindy Bohnas
12775 Deer Crest Dr SW
Port Orchard, WA 98367

When Completed