Mail Application To: Kathryn Hazlett 402 W. Rolling Hills Conroe, TX 77304 Home: 936-890-9133 Cell: 936-537-0077 Email: kathrynhazlett@yahoo.com Website address: www.nhvwclub.org

Membership Application

New______ (Sponsored by:____________________________________ ) Renewal:___________

Name:_________________________________________________________________________

Spouse’s Name:_________________________________________________________________

Address:_______________________________________________________________________

City:________________________________ State:_____________ Zip Code________________

Home Phone:________________ Bus. Phone:_______________ Cell Phone__________________

E-Mail Address:_________________________________________________________________

Employer:______________________________________________________________________

Occupation:____________________________________________________________________

Type(s)of Volkswagen(s):__________________________________________________________

Interests: shows_____ competition______ restoration_______ other_____________________

TYPE OF MEMBERSHIP

Household Membership ($20) yr___________ Sponsor ($75) yr__________

(Make checks payable to: North Houston VW Club)

______________________________________________________ _____________________

Signature Date

Note: Your membership dues will entitled you to a Club Card which will enable you to shop at Kars and Bap Geon (www.bap-geon.com/) and received a 10% discount on items that you purchase.