Instructions: Membership in the I&I Antique Tractor & gas Engine Club requires a fee of $25.00, annually. Membership is good for a period of one year and expires, December 31 of each year. (Make checks payable to I & I Antique Tractor and Gas Engine Club) Dues may be pro-rated depending on when applications are submitted. Dues required for this application are $____.00. Club news, announcements of events and reports of club meetings are mailed to members on a monthly basis.

Date:_____________                          Membership Type: _____ Regular ____Junior ____Senior ____ Other

Name: ________________________________________________________________________________________
                                    Last                                                                First                                      MI

Spouse Name: __________________________   Interest in Women’s Auxiliary?                      Yes                      No

Address: _______________________________________________________________________________________
                                                  Street                                                     City                           State                Zip

Phone: ( _____) _____________________ (______) __________________________________
                          Home                                                      Work/Shop/Mobile/Pager

Name Tags are $5.00 each. Would you like name tags? Self: Yes___ No___ Spouse:Yes___ No___

Member Information:

Special Equipment: i.e. loader, boom truck, trailers, trenchers, backhoe, other? ________________

Special Skills: i.e. Electrician, Plumber, Carpenter, Other ______________________________________

Committee Interest? Summer Show, Buildings & Grounds, Fixed Assets, Membership, Swap Meet, Raffle Tractor, Donations, Web page, other. _____________________

Days of the week you might be able to work on Club Projects:   Mon. ____ Tues. ____ Weds. ____ Thurs. ____ Fri. ____ Sat. ____ Sun. ____

Show projects on which you would be willing to work: i.e. Threshing, Plowing, Saw Mill, Tractor Pulling, Display, Feature Tractor, Field Demos, Trading Post, Flea market, Other __________________.

Collectors Items: (This information is used to help locate exhibitors. Please indicate condition, i.e. restored, original, un-restored)

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