Kia Pride Club Membership Form
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- Words: 214
- Pages: 2
Form No:
KPC 1-A
Rev. :
1a
Revision Date :
10/2/2008
Effective Date :
10/2/2008 Pls attach 1x1 ID photo on this side
Club website: Look for Local Chapters/Cebu Chapter Sub-board
Car Club Membership Form Family Name: First Name: Middle name LTO License No. Complete Address:
Date: Nickname: Birthdate: Birthplace:
Forum Username:
Zip Code: Email Address: Home Tel. Number: Office Address: Office Tel. No.: Occupation: Business (if any): Skills/Expertise:
Mobile Number: Office/Home Fax No.: In the field of:
Vehicles owned:(current)
(make,model,year)
(plate number)
(fuel)
What are your interest: (check as many as you wish) Car Maintenance Car Modification/Tuning Restoration Car Audio Enthusiast Car Show
Drag racing Others:____________________ Autocross ________ ____________ Drifting ________ ____________ Rally ________ ____________ Roadtrip Social Any Notable Hobbies, other interest,etc:
If a member has a car problem near you can you offer Roadside Help/Assistance? Please check:
Yes
No
If YES, when wouldn't you mind being contacted:
Days
Evenings
Nights
Weekends
Past 12MN or early morning
Please provide youre preferred contact number for this purpose:
In case of emergency please notify the following contact persons below: Name & contact no.
The undersigned is a bonafide member of the Kia Pride Club Cebu Chapter and entitled to all rights and privileges due to a member. Signature over Printed Name EB's attended:_______________
Verified by:
KPC 1-A
Rev. :
1a
Revision Date :
10/2/2008
Effective Date :
10/2/2008 Pls attach 1x1 ID photo on this side
Club website: Look for Local Chapters/Cebu Chapter Sub-board
Car Club Membership Form Family Name: First Name: Middle name LTO License No. Complete Address:
Date: Nickname: Birthdate: Birthplace:
Forum Username:
Zip Code: Email Address: Home Tel. Number: Office Address: Office Tel. No.: Occupation: Business (if any): Skills/Expertise:
Mobile Number: Office/Home Fax No.: In the field of:
Vehicles owned:(current)
(make,model,year)
(plate number)
(fuel)
What are your interest: (check as many as you wish) Car Maintenance Car Modification/Tuning Restoration Car Audio Enthusiast Car Show
Drag racing Others:____________________ Autocross ________ ____________ Drifting ________ ____________ Rally ________ ____________ Roadtrip Social Any Notable Hobbies, other interest,etc:
If a member has a car problem near you can you offer Roadside Help/Assistance? Please check:
Yes
No
If YES, when wouldn't you mind being contacted:
Days
Evenings
Nights
Weekends
Past 12MN or early morning
Please provide youre preferred contact number for this purpose:
In case of emergency please notify the following contact persons below: Name & contact no.
The undersigned is a bonafide member of the Kia Pride Club Cebu Chapter and entitled to all rights and privileges due to a member. Signature over Printed Name EB's attended:_______________
Verified by:
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