TRFCC Printable Form

TRF CAR CLUB MEMBERSHIP FORM
for Printing and Mailing or Faxing

If you are going to join this club by any means other than by phone, we suggest the following ways: print this form out and mail it or fax it to us.

Name

________________________________________________

TRF Customer Number

_____________

Daytime Phone	________________________________	Evening Phone	______________________________
Email	______________________________

Shipipng Address	Please provide a shipping address if your mailing address is a Post Office Box
Street Address	_________________________________________________________________________
City	_________________________________________________________________________
State	___________________________________________________	Zip	_______________

Method of Payment:

Credit Card

___ VISA
___ Master Card
___ Discover
___ American Express

Card No. _________________________________________

Expiration Date: ___________________________________

Card Holder Name: ________________________________

Card Holder Signature: _____________________________

Billing Address If different from Mailing address above
P.O. Box or Street	________________________________________
City	________________________________________
State	___________________________	Zip	________

___ Personal Check
___ Cashier's Check or Money Orders

If you wish to call in your credit card number by telephone, we will keep a record of it until we receive your membership form. Call Toll Free: 800-678-8764


Mail this form with payment to:	The Roadster Factory P.O. BOX 332 Armagh, PA 15920	Or FAX to:	814-446-6729

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