ANNUAL MEMBERSHIP FEE $10.00

(each additional immediate family membership $5.00)

Full Membership package includes: HOPRA National Rulebook, HOPRA Membership Card (good for discounts at many state, regional, and national races) 2 HOPRA logo stickers and any National HOPRA Mailings (additional family memberships do not include rulebook).

 

PLEASE PRINT

 

NAME: ________________________________________________________

 

ADDRESS: ____________________________________________________

 

CITY: ___________________________  STATE:_____  ZIP: _____________

 

PHONE: _______________________  E-MAIL: ________________________

 

STATE/REGIONAL GROUP: ______________________________________

 

LOCAL RACING GROUP: ________________________________________

 

NEW MEMBERSHIP _____     FAMILY MEMBERSHIP _____

 

RENEWAL _____     MEMBERSHIP # __________________

 

All information is for HOPRA use only

All proceeds from memberships go to support

Annual HOPRA National Championships

_______________________________________________________________________

(FOR HOPRA USE ONLY)

 

PAID _____  RECV. BY: _____________________  EXP. DATE: ____________

 

MEMBERSHIP PKG. SENT _____  MEMBERSHIP # __________

 

DRIVER CLASSIFICATION:  AMATEUR _____  PRO _____

 

MAIL CHECK OR MONEY ORDER PAYABLE TO:

Paul Reeve

1080 Perkins Dr.

Wooster, OH 44691

 

(PRINT OUT FORM)