CENTRAL ILLINOIS CRUISERS
 CAR CLUB, INC.
MEMBERSHIP FORM 2010

Dues:  $10.00
Benefits to becoming a Member of the Central Illinois Cruisers, Inc.:

• Membership card
• Window Sticker
• Newsletters
• Mailings of up-coming events in the area
• Chance to have your car placed on T-Shirt for next season
• Recognition on our website
• Chance to win an Award Plaque for helping at events

Name:_______________________________________

Address:_____________________________________

City:__________________ST:______Zip:__________

Phone:__________________  Cell:________________

E-Mail:______________________________________
Car/Truck Info:

Year:_____Make & Model:____________________________Color: ____________
Any other Cars/Trucks
Year:_____Make & Model_____________________________Color:____________

Year:_____Make & Model_____________________________Color:____________

If you would like to help at some of our cruises please check what you’d be interested in helping with:
_____ Memberships/T-Shirt sales
_____ Directing/Parking Cruisers        (we will contact you when needed, we’d like to get members
_____ Passing out fliers                                               more involved in our events)

make checks payable to: Central Illinois Cruisers
Please return form and dues to Amanda or mail to:
Central Illinois Cruisers
4719 N. Edgebrook Dr.
Peoria, IL  61614