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COPPER STATE CRUISERS
MEMBERSHIP APPLICATION
(CHECK ONE)
New Member_____ Renewal____ If Renewal, What is you current member
number?:___________
Name:______________________________________________________ Birth Date:
_____/______/_______
IH8MUD Name if applicable:
________________________________________________________________
Spouse:_________________________________________________________________________________
Children:
Name/Age____________________,____________________,____________________,_________________
Address:_________________________________________________________________________________
________________________________________________________________________________________
Email Address:____________________________________
Phone:__________________________________
Toyota’s you own:
(Year/model)_____________________________________________________________________________
________________________________________________________________________________________
Are you affiliated with any other 4wheel drive clubs or associations?
Yes____ No____
If yes, which
ones?_________________________________________________________________________
How did you find out about
us?_______________________________________________________________
________________________________________________________________________________________
Shirt Size (1w/ Paid membership) :_______ Additional shirts:_____
Sizes:____________ Add/stickers_____
Pleas add $2 to membership fee if you would like 2XL or 3XL shirts
Additional shirt and sticker pricing as follows:
Shirts S-XL $15 each, XXL-XXXL $17 each, Stickers $4 each
Membership Fees and Benefits
Yearly membership fee $20
Membership fees are due January 1st of each year. Fees are not pro-rated
for members who join later in the .
With every new membership and renewal you will receive 1 Club t-shirt
(Size: S,M,L,XL) , 1 CSC logo sticker, and a copy of the club’s State
Trust Land permit (This alone holds a 20 dollar value).
Additional shirts and stickers are available at an added cost. If
membership package can't be picked up the shipping charge is $4.00
Make checks payable to:
Philip In-Albon
C/O Copper State Cruisers membership
6623 E Aster Dr
Scottsdale AZ 85254
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