Application for Membership

 

Mail Form To:

 

            The Willys-Overland-Knight Registry, Inc.

            Duane Perrin, Registrar

            4177 Spring Hill Road

            Staunton, VA 24401

            USA

 

Please Print:

 

 


            First and Last Name of Applicant                                  First Name of Spouse or Joint Member

 

 


            Address                                   City                              State/Province              Zip/Postal Code

 

 


            Country                                    Telephone                    Fax Number                 E-Mail Address

 

 

Were you ever a member of W.O.K.R.?    Yes______ No______

 

How did you learn about W.O.K.R.?  ___________________________________________________

 

___________________________________________________

I will comply with the W.O.K.R., Inc. By-Laws.           (Signature)

 

 

                                                                                    List Your Collection

                                    Overland, Willys-Overland, Willys (up to 1942), Whippet, & Knight engine vehicles only

 


        Year                Make                      Model            Cyl          Body Style         Serial No.          Engine No.      Condition

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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