The Packard Motor Car Foundation

P.O. Box 182063

Shelby Twp., MI 48318-2063

 

FRIENDS OF THE PROVING GROUNDS

Printable Membership Form

(Use your "Print" icon on your browser or on the "File" menu or Google browser menu)

 

            Name ___________________________________________________________________

 

            Address _________________________________________________________________

 

            City _____________________________ State ______________ Zip Code ____________

 

            Overseas please provide Country _____________________________________________

         

    ______ $30 Individual

 

    ______ $20 Individual Senior (60+)

 

    ______ $45 Family

 

    ______ $100 Contributor

 

    ______ $250 Supporter

 

    ______ $500 Benefactor

 

    ______ $1000 Life 

 

             By Check: payable to: The Packard Motor Car Foundation or

 

            By Credit Card:

            Fill in your ______Visa, ______MasterCard, ______Discover, or ______American Express 

                

            Card number: ________ ________ ________ ________ Expiration date: ____   ____

                                                                                                                                     (mm)   (yy)

            Name and billing address on card must match the name and address above.

           

            and mail it to:      Packard Motor Car Foundation

                                        PO Box 182063

                                        Shelby Twp., MI 48318-2063

 

Thank you for your support. We look forward to your joining the friends.

 

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