Jaguar Clubs of North America, Inc.
Name (First): (Last): Date:
Significant Other (First,): (Last):
Address: City: State: Zip:
Phone Home: Cell: Work: Email Address:
Occupation: Member: Spouse:
Other Club Affiliation:
1st Car Make: Year: Model: 2nd Car Make: Year: Model: 3rd Car Make: Year: Model:
On a scale of 1-5 how likely would YOU like to take part in the following events: (1= Not likely 2 = Possibly 3 = Neutral 4 = Likely 5 = Very likely)
Rallys: Tours: Tech Sessions: Mo. Dinner Meetings: Concours: Autocross: Car Shows:
List any events you would like that are not mentioned above:
Completion of this application and your dues payment (amount below) will enroll you in JCNA (Jaguar Clubs of North America) as well as JDCNT. The data you supply is held in confidence by JDCNT and used for Association purposes only.
I have read, understood and agree to abide by the BYLAWS of JDCNT.
Full Name:
Annual dues $69.00 (If joining January 1-June 30) Partial dues $36.00 (If joining July 1-December 31)
Note: If you have paid JCNA dues through another club you pay $47.00 (rather than $69) or $24.00 (rather than $36).
