Western Idaho Model T Club

Application

                                                                                                                          Membership Application                    

To join the Western Idaho Model T Club (WIMTC), please submit this form by clicking submit button below
and mail your payment of $15 to: WIMTC, 3590 Jullion Street, Boise, ID 83704
Once you click the submit button it will return you to our "Home" page.
                                 

First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
State:
Daytime Phone:
Evening Phone:
Email:
Model T or other vintage cars owned
Year, Body Style, Condition etc.
Insurance Carrier:  
Spouses name (if applicable):  
Model T Ford Club of America Membership I.D#
(Can be obtained by calling in)
 

Thank you for your interest in The Western Idaho Model T Club.  We look forward to seeing you at our next meeting. 
              

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