Name ____________________________________________________________________________
  

  Address _________________________________________________________________________
  

  City _________________________ State ____ Zip _______  Telephone ________________
  

  E-Mail Address ___________________________   Referred By: _______________________
  

Year        ______________ ______________ ______________ ______________ ______________
  

Model       ______________ ______________ ______________ ______________ ______________
  

Body Style  ______________ ______________ ______________ ______________ ______________
  

Serial No   ______________ ______________ ______________ ______________ ______________
  

Color       ______________ ______________ ______________ ______________ ______________
  

Purchased   ______________ ______________ ______________ ______________ ______________
New or Used
  

Engine/     ______________ ______________ ______________ ______________ ______________
Transmission
  

*Use        ______________ ______________ ______________ ______________ ______________
                     *Show car, parts car, transportation, excess, etc.  

I _____________________ hereby apply for membership in the EDSEL OWNERS CLUB, INC. and have enclosed United States - $35.00, Canada - $40.00 (U.S. Funds), All others - $45.00 (U.S. Funds) as my annual membership dues for the year 2008, $30.00 of this amount is for a subscription to "The BIG E" for one year. All foreign memberships must be submitted in U.S. funds.

ARE YOU MOVING? CHANGE OF ADDRESS
Please forward your address to: Jeannine Phipps, 2500 N.E. 187th Avenue, Vancouver, WA 98684-9730 OR click here to email change of address

Name _________________________     Street __________________________________
City _______________________  State ____  Zip _________  Phone _____________