MEMBERSHIP APPLICATION

Please print and fill out this form, include your payment, and mail to the address below. Note to Non-USA applicants: Send fee in U.S. funds on a U.S.-based bank or U.S. Cash. A non-U.S. postal money order—even in U.S. dollars—is NOT acceptable.
TYPE OF ANNUAL MEMBERSHIP (check one)
Individual $20/year
Family $30/year
Overseas Individual
   Higher fee covers Overseas mailing of newsletter		 $30/year
Kid's Club $10/year
Business
   Business members get one free business card ad, so enclose your card		 $49/year
Date:  
Name:  
Business Name:  
Address:  
City, State, Zip:  
Country:  
Home phone:  
Business phone:  
Fax no.:  
Email:  
CC#, Type*, Expiration:
*We accept MasterCard and Visa at this time.		  
Name as it appears on CC:  
Signature*:
*We must have your signature if you are paying by credit card!		  
Mail to:
Oklahoma Route 66 Association
PO Box 446
Chandler, OK 74834
NOTE: Bad checks will incur a $35 recovery charge.		 Thank You!

Your membership information will be mailed to you upon receipt of your payment.