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I.D.R.A. 2006 Membership Application

Please print & complete this form

Name__________________________________
Address________________________________
City___________________________________ Postal Code_____________
Work Phone_____________________________
Home Phone_____________________________
e-mail Address___________________________

Membership numbers available are 11 to 599

1st Choice__________
2nd Choice__________

Memberships are $25.00.

Memberships can be mailed with cheque to:

ISLAND DRAG RACING ASSOCIATION
491 BIRCH ST S
CAMPBELL RIVER BC V9W 6A7

For more information contact:

Mo Anderson at 250-956-4347 or
Stan Cook at 250-286-1321

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