NAMGBR Membership Application

Mail or Fax this form or a copy of it to submit your application.

IF YOU PREFER YOU CAN JOIN/RENEW ON LINE THROUGH OUR SECURE SERVER JUST CLICK HERE

Name: __________________________________________________________________________

Address: ________________________________________________________________________

City/State/Prov/Zip/Postal Code:_______________________________________________________________

Country: ______________________________________E-mail :________________________________________

Home Phone: ________________________________________

Work Phone: ________________________________________

May we list your Phone Number(s) as an emergency contact should a Register Member traveling through your area need assistance? Yes __________ No__________

Where did you learn of the Register? __________________________________________________________________________

Which local MG or British Car Club(s) do you belong to?__________________________________________________________________

How many MGBs __________ Midgets __________ 11/1300s __________
RV8s __________ MGFs __________ do you own?

What Other British Cars do you own?_____________________________________________________________

Enclose your check or credit card information and return to:

The North American MGB Register
P.O. Box 55
Whittington, IL 62897-0055

or fax to: 1-800-NAMGBR-1

One year membership is $30.00 U.S. ($35.00 Overseas)
and includes our bi-monthly publication "MGB Driver"

Visa/MasterCard # ________________________________________ Exp. Date: __________

Signature ____________________________________________________________