Membership Application for the
Hampton Roads Chapter
Of the Studebaker Drivers Club, Inc.

Name:                 Birthday:  

Spouse's Name: Birthday:  

Children's Names: Birthday:  

Children's Names: Birthday:  

Children's Names: Birthday:  

Children's Names: Birthday:  

Address:

City:  State:   Zip:

Telephone (Home): (Work):

Fax: (Other Phone):

E-mail address:

         Car 1:    Car2:

         Car 3:    Car4:

         Car 5:    Car6:

(Please list additional cars on a separate sheet of paper.)

SDC Membership #:    Do you need to join SDC? yesno

(Membership in the national Studebaker Drivers Club is required for membership in a local chapter.)

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