High Desert Cruisers
Prospective Member Application
Name:___________________________________________________
Address:_________________________________________________
_________________________________________________
_________________________________________________
Email: _____________________
Phone: (H)_____________________ (W)_____________________
Birthdate (m/d/y): _________________ TLCA #: ______________
(Required, HDC members must also be TLCA members)
Vehicle Information
Make:______________________________ Year:____________
Model:__________________________________________________
Insurance Information
Policy Holder:_______________________________
Policy Number:______________________________
I have read the by-laws of the High Desert Cruisers and agree to abide
by them.
Signed:________________________________ Date:___________________
Membership dues are $20 and due January 1st.
Dues after July 1st are $10.
Mail application and dues to:
Skipper Brown
5505 Pegasus Place N.W.
Albuquerque, NM 87120
(505)890-7750
If writing a check
for dues, please make
it payable to Skipper Brown.
For more information,
contact:
Treasurer: Skipper Brown
President: Shawn Williams
(505)
896-9635