Oregon Chapter Edsel Owners Club
Membership Application Form

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Your Name

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Spouse or Significant Other

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Address

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Phone Number

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E-Mail Address

Tell Us About Your Edsel(s)!

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Year/Model

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Body Style/Color

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First Line of Data Plate (VIN#)

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Second Line Of Data Plate               Model Color   Trim     Date    Trans   Axle

I’ve enclosed ($10.00) ______ for local dues and/or ($35.00)  ______ for my national dues. ($45 for both)

Mail Your Completed Form and your check made out to “The Oregon Chapter of the Edsel Owners Club” to:

Lois Roth
Oregon Edsel Owners Club Treasurer
1740 NW Third Street
Gresham, OR 97030
(503) 492-0878