Southeast Chapter Membership Form

To join TMC:SE simply print, fill out, and mail our membership application:

Name:

Address:

City:

State:

Zip:

Tel/Work:

Tel/Home:

Tel/Mobile:

e-mail address:

Maserati (#1) /Year:

Maserati (#1) /Model:

Maserati (#1) /Serial#:

Maserati (#2) /Year:

Maserati (#2) /Model:

Maserati (#2) /Serial#:

Regular Maserati Mechanic:

Mechanics' Phone #:
 

Send this form with a check made out to "The Maserati Club" for one of the following:

$65 Regular U.S. membership
$160+ Patron U.S. membership
$90 Regular foreign membership (see "Global Chapter")
$180+ Patron foreign membership  (see "Global Chapter")

Send to:

TMC: Southeast Chapter
Michael A. Demyanovich
325 Walden Avenue
Harriman, TN 37748

USA

If paying by credit card you can fax it in (732.246.7570), call it (732.249.2177), or email it (email@themaseraticlub.com).

Credit card information (circle or mark choice):

VISA
MC
AMEX

Your card number__________________________________________________________________

Expires: ________________________________________________________

Your Signature (only if faxing or mailing): ____________________________________________

 


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