Name:

Birthday Month and Day:

Spouse/Significant Other:

Birthday Month and Day:

Street Address:

City     State      Zip Code

Home Phone:   Cell number

Occupation: Company Name: 

If you have E-mail, what is your E-mail address:

How would you like to be contacted? cell e-mail home Phone

How did you learn about the Boulevard Knights Car Club?

What are things that you would like see or do with in your car club?

    

Are you willing to help with club duties or organizing events? no yes

Are you interested in holding an officer title within the Club?   no yes

Do you have any skills that would be beneficial to the club (i.e. Mechanic, Graphic design ect.) no yes

What events Interest you most (check all that apply)

Cruises Shows Poker Runs Long distance Cruises

How many event would you say you attend on average?
0-2 per month 2-4 per month 5-8 per month 8-10 per month 10+

Tell us about your Car

Year                                      Make           &           Model of your car

Exterior Color:      Interior Color:

Engine & Transmission

Options:

How would you describe your car? (check all that apply)
 

original Un-restored original restored mild modified race car modified/custom daily driver show car other

Do you have more than one Car?  no yes
 

Year                                      Make           &           Model of your car

Exterior Color: Interior Color:

Engine & Transmission

Options:

How would you describe your car? (check all that apply)

original Un-restored original restored mild modified race car modified/custom daily driver show car other

Are you a member of Any other Car Clubs? no yes   if yes which one?  

Do you own your own business or have a side business? no    yes

If so, what is the name of the business?    

Discount available to BKCC Members? no  yes

If so, How much?