POCI MEMBERSHIP APPLICATION/

POCI MEMBERSHIP APPLICATION/
RENEWAL FORM

Fill out the from below or send $31.00 check or money order (US funds only) to Pontiac-Oakland Club International P.O. Box 539, Victor NY 14564
Be sure to send in your Pontiac and/or Oakland car information also.

Name and Address:
Application Type:	New MemberA Renewing Member
POCI # (For Renewals Only)
E-Mail Address:
New Member Referral?	If a current member refered you please give us their name.
MEMBERSHIP TYPE
U.S. ($31.00)AAAAA CANADA ($33.00) OTHER COUNTRIES ($42.00) aaASSOCIATES ($2.00 each)
Associate Member 1:
Associate Member 2:

VEHICLE TYPE INFORMATION
	Year	Style Number	Style

	Year	Style Number	Style

	Year	Style Number	Style

	Year	Style Number

(After filling this application, print out the form and mail in)