49th State - Street Rodders
P.O. Box 891
Palmer, AK 99645
Name:________________________________________________
Address:______________________________________________
City:_________________ State:_____________ Zip:_________
Phone:__________________ Cell:_______________________
**EMAIL: ____________________________________________
Types of Vehicle(s) Owned:_____________________________
____________________________________________________
____________________________________________________
Spouse & Children:___________________________________
I, would like to apply for membership in the 49th State - Street Rodders. Register and enclose
my fee of $35.00 for one (1) Year Membership.
** This information is needed to keep you posted on important cruises, parties, etc. Information
on your car is needed to be able to send your pictures to magazines that sometimes cover our events!
Mail Applications
and Check Payable to:
49th State - Street Rodders
P.O. Box 891
Palmer, AK 99645
