FIAT LANCIA UNLIMITED (FLU)

MEMBERSHIP APPLICATION


Print out, fill in and mail today!


Name____________________________Spouse__________ ******__New Member

Address__________________________________________ ******__Renewal

City/State/Zip_____________________________________

Telephone (H) ( ) _________ ) ( )______________

ITALIAN CARS OWNED

(Year, Make, Model )

_______________________________________________________

_______________________________________________________

_______________________________________________________

_______________________________________________________

How did you hear about FLU?__Bruce Matthews'Home Page, ________

_______________________________________________________

Please indicate your interests:

__ Technical __ Vintage Cars __ Autrocross __ Tours __ Social __ Rally

DUES:

$28.00 per year

____ Rush my newsleter first class mail (add $6.00 for postage)

MAKE CHECK PAYABLE TO:

Fiat Lancia Unlimited

MAIL TO: FLU, P.O. Box 193, Shillington,Pa. 19607


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