Date: ______________

Name: _____________________                           Spouse: _______________                     

Address: _____________________________       Phone:                                                      

                                                                                E-mail __________________________

Children (living at home): __________________________________________________

Birthdays (Month & Day): Member: ______________ Spouse: __________________

Children’s Birthdays: _____________________________________________________

List Military Vehicles: ____________________________________________________

_______________________________________________________________________

(It is not necessary to own a military vehicle to become a member)

If a member of the National MVPA, list your number: ___________

ANNUAL DUES:

Member or member and spouse: $15.00 _________

Associate member: (business/club) $25.00 _________ (Send a business card so we can advertise your business or club in the quarterly newsletter)

All members receive a quarterly newsletter and can place free classified ads in the newsletter and on the web page. www.armvpa.com

Mail a copy of this form and dues, payable to AR MVPA, to:

    Evelyn Harless, Secretary;

    1279 Ada Valley Rd.;

    Adona, AR 72001

For additional information contact Paul Harless at plheh@cyberback.com 

*Arkansas MVPA encourages all members to join the National MVPA:  WWW.MVPA.ORG