Member Details Form

Name:

Address:

City: Province/State:

Postal/Zip Code: Phone:

E-mail address:

Vehicle Year: Model: Engine:

Transmission: Color:

Please include notable vehicle options or features below, or personal comments, or list out your other AMC vehicles:

Add pictures and send it by mail to:

AMC Manitoba Car Club
Box 548
Warren, MB R0C 3E0