Annual Membership Dues: Individual - $30 Family - $45
To join or to renew, please complete this online application. (Renewing members, please fill out this form so we know your information is current). Then mail your check or money order for the appropriate dues amount to:
Mopar Magic Unlimited Auto Club, Inc.; PO Box 52081 Shreveport, LA 71135
New members receive a club t-shirt, window decal, monthly newsletter and admission to special club events!
Thanks, and welcome to the Club!
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MoPar Magic Club Membership Application
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Your First Name: *
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Your Spouse's First Name:
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Your Last Name: *
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Your Spouse's Last Name:
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Your Birthday (MM/DD):
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Your Spouse's Birthday (MM/DD):
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Street Address: *
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City: *
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State: *
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Zip Code: *
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Home Phone (XXX) XXX-XXXX*
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E-Mail Address
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Work Phone (XXX) XXX-XXXX
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Occupation
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* indicates required field
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Please List Mopars Owned. (Optional - Ownership is not required for membership.)
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T-Shirt Size(s)
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Family Members' Names and Dates of Birth - If you'd like announcements in the newsletter.
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NOTE FOR CURRENT MEMBERS
DO NOT use this form for ANNUAL RENEWAL OF MEMBERSHIP!
This form is for NEW member applications ONLY!!!
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