Minnesota Street Rod Association

Online Membership Application

with Visa/MasterCard!

Memberships Expire December 31 Each Year!

  


We Gladly Accept:


 

New Member Application

Apply for MSRA Membership Online:

1.

Click the boxes below and enter your information.
2.

Click the "Submit Application" button at the bottom.
3. Complete the credit card information for online payment.

Personal Information:

Name:
Spouse:
Address 1:
Address 2:
City:
State:

Zip Code:

+4

Province:
Country:

Date of Birth:

/ /
(Mo / Day / Year)
Children's Names:
Phone:

Area Code: Phone Number:    

Nickname:

I belong to the following car clubs:
Have you been a member of the MSRA in the past?
If yes, what was your MSRA Number?

Vehicle Information:

Vehicle 1: Coupe

 2-Door Sedan
 		4-Door Sedan
 		Convertible

 Roadster

 		Sedan Delivery
 		Pickup
Vehicle 2: Coupe

 2-Door Sedan
 		4-Door Sedan
 		Convertible

 Roadster

 		Sedan Delivery
 		Pickup
Vehicle 3: Coupe

 2-Door Sedan
 		4-Door Sedan
 		Convertible

 Roadster

 		Sedan Delivery
 		Pickup

Membership Dues (US Dollars Only):

Annual Membership: √ Fee:
US Dollars		 Joining MSRA allows full membership benefits through December 31 of the current year.  This includes all member functions, as well as receipt of the MSRA monthly LineChaser® publication.
USA

$25.00

USA resident only.
Canada: $30.00 Canada resident is $5.00 additional.
 
Lifetime Membership:

√

Fee:
US Dollars

 Lifetime membership in the MSRA allows full membership for life.  This includes all member functions, as well as receipt of the MSRA monthly LineChaser® publication.
USA

$450.00

USA resident only.
Canada:

$500.00

 Canada resident is $50.00 additional.

Be sure your application is complete and then click Submit Application:

Tim Taylor
MSRA Web Master
Copyright © 2008. Minnesota Street Rod Association. All rights reserved.