HEART OF TEXAS PACKARDS

REGIONAL MEMBERSHIP APPLICATION

(Please Print)

Name Birthday

Spouse Birthday

Address: Anniversary Date:

City: State: Zip: Home No. ( )

Fax No. ( ) Work No. ( )

Email Address Cell No. ( )

Automobiles Owned:

YEAR SERIES MODEL # ADDITIONAL DESCRIPTION STYLE BODY STYLE FEATURES

(You may enclose a photograph of your car(s), if you like.)

Regional Dues Information: National Dues Information:

Annual Family Membership: $ 10.00 Annual Family Membership: $ 40.00

Life Membership: $150.00 Life Membership: $1,000.00

General Information:

>National membership in Packard Automobile Classics (PAC) is a prerequisite for membership in the Heart of

Texas Packard Region. Please apply directly with the national organization.

>Please make check or money order payable to Heart of Texas Packards for regional membership.

>New membership regional dues received after September 1st shall apply to the remainder of that year and the

next full year.

Mail Completed Application to:

Heart of Texas Packards

Beverly Clark Applicant’s Signature

735 Ware Blvd.

San Antonio, TX 78221 Date: