Lilac City Mopars Unlimited
Spokane, Washington


Membership Application

Our purpose is to promote the preservation and restoration of all Mopar related Autos.



Date ______________________________ New               Renewal    

Name _________________________________________________________________ Birth Date ________________________

Spouse ________________________________________________________________ Birth Date ________________________

Address _______________________________________________________________ Phone ___________________________

City ____________________________________________________ State _______________________Zip_________________

Occupation __________________________________________________________________________________________

Spouse Occupation________________________________________________________________________________

E-Mail Address ___________________________________________ Web Site ____________________________________

Make & Model of Mopar Auto’s (List up to five) _______________________________________________________________

________________________________________________________________________________________________________

Would you be interested in a Board member or committee job? Yes No Maybe

If so, what qualifications or interest do you have______________________________________________________________

________________________________________________________________________________________________________


Any suggestions as to the type of activities in which you would like to see the club participate?

________________________________________________________________________________________________________

Please return completed form and $ 25.00 membership dues to: Lilac City Mopars Unlimited
P.O. Box 7206
Spokane, Washington 99207

Membership entitles you to the following: Club T Shirt,  Membership card, Newsletter, and parts discounts at participating dealers/businesses.

FOR MORE INFORMATION CALL:
Dean Churchill - 951-3976     Dave Davis 847-5562   Mike Sparlin 926-2421