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Please be fair and only call up untill 8 p.m. EST
E-mail us anytime. Send in your membership today!

ZANY Eastern and Western Chapter Contacts:
East: Chris Holmes
194 Stow Ave
Troy, NY 12180
PH: 518-273-9568
E-mail: cakholmes@aol.com

West: David Palermo

Rochester, NY
PH:
E-mail: dapamp@aol.com

Send all membership dues, along with membership form below, to either adress above. Confirmation along with your member # and Club Sticker will be mailed to you within 30 Days. Please call one of the contacts if you are not sure which chapter to Join.

Email:
cakholmes@aol.com

Website:

MEMBERSHIP FORM

NAME:________________________________________

ADRESS:STREET:_______________________________

CITY:_____________, STATE:______,

ZIP:______________

PHONE: (___)_____-________

E-MAIL:_______________________________________

VEHICLE PROFILE:

YR:____, MODEL:_______________________________

(check one) STOCK___, MODIFIED___, ULTRA MOD___
DAILY DRIVER___

COLOR:(EXT)_______________ (INT)___________

PLEASE TELL US A LITTLE ABOUT YOURSELF AND YOUR CAR HISTORY:____________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ___________________________________________________

MEMBERSHIP (please check one)

__INDIVIDUAL Twenty Five Dollars ANNUALLY

__FAMILY Thirty Dollars ANNUALLY

__ASSOCIATE Fifteen Dollars ANNUALLY

(membership autmaticly entitles you to all the discounts and bennefits of joining the ZANY organization)