 |
|
Print Form
|
|
|
Print Form
|
Instructions: Please print out this document, fill it out and send it along with payment to the address listed below or click on the "Online Form to apply and pay online. The International 190SL Group, Inc., is a not for profit club founded for 190SL enthusiasts who desire more knowledge about the car and the restoration of it. Ownership of a 190SL is NOT required, and those that are contemplating the purchase of a 190SL will find much value in Group membership prior to the purchase of a 190SL. The 190SL Group is not associated with Mercedes-Benz of North America, or the Mercedes-Benz Club of America
Name in full____________________________________________ Spouse’s Name: ____________________
Street Address: ____________________________City: ________________State: _____Zip: ____________
Phone Number: _______________________________ Work Phone: _______________________________
Year of 190SL: ____________Serial Number: _____________________ Years owned: _________________
Tops(s) and Color: Conv: __________ Hardtop: ___________ Body Color: _________ Interior Color:________
Please list optional equipment: _______________________________________________________________
The present condition of my car can best be described as: ___________________________________________
My plans for the car are to : __________________________________________________________________
Other Mercedes-Benz clubs of which you are a member: ____________________________________________
Is there any special area that the Group could help you with towards reaching the goal you have planned for you car? _______________________________________________________________________________________
Is there some area of expertise you posses and would be willing to lend to the group?______________________
_______________________________________________________________________________________
We also publish annually a national list of members’ names and phone numbers. This list is for members’ use only and not to be used for commercial purposes.
I hereby apply for membership in the 190SL Group and agree to abide by their by laws and not use the membership list for commercial purposes nor to give out.
Applicant’s Signature______________________________________________ Date: _________________
Method of payment: † My check or money order enclosed, or pay by credit card
|
Credit Card |
Card Number |
Expiration date |
|
† Visa † Master Card |
|
|
Yearly dues are $35.00 (U.S.A.) $40 (Canada), $45 (International) in U.S. funds.
Please forward application and check payable to the 190SL Group to:
190SL Group, 258 E. Paul Revere Dr. Chesterton, IN. 46304
Or email to :dafreese01@aol.com
Thank you for your application to the 190SL Group,
Shirley Freese, Membership Manager, (219) 926-3216
Tom Hamilton, President, (716) 385-2338