MEMBERSHIP APPLICATION
To join MOOV (Miata Owners Of Vegas) please print form, fill out completely, 
and submit with a check for $30.00 made out to MOOV.  Mail to Shirley Bujnovsky, 
Membership Chair, 8129 Bay Colony Street, Las Vegas, NV 89131-6707. If you have 
any questions please call 702-360-9718 or e-mail johnshirley1@embarqmail.com

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MOOV
 Miata Owners Of Vegas

NAME(S) _____________________________________________________________

ADDRESS_____________________________________________________________

CITY________________________________________________ZIP______________

PHONE _______________________E-MAIL__________________________________

CELL PHONE _______________BIRTHDAY 1 ___________BIRTHDAY 2 ___________
                                                            month & date only-no year)

CAR COLOR____________________________________YEAR___________________

We have a club roster for members use only. If you would like to be included 
please initial for each item.     
        

                Yes               No                                              Yes            No
Name        _______        _______
Phone        _______        _______                 Cell Phone       _______     _______
E-mail       _______        _______                  Birthdays        _______     _______

If at some future date the club may be asked by a dealer or vendor for a 
membership list. Do you want to be included?   
             Yes________ No_______

Signature____________________________________________Date________________

 
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