Name: ______________________________ Spouse (if married):_____________________ Preferred Name:_____________________ Preferred Name:__________________________ Employer: __________________________ Employer:________________________________ Occupation: ________________________ Occupation: _____________________________ Work Phone: ________________________ Work Phone: _____________________________ Fax: _______________________________ Fax: ____________________________________ E-Mail Address: ____________________ Mail Address: ___________________________ Birthday (Month/Day): ______________ Spouse's Birthday (Month/Day): __________
Street: _______________________________________________________ Apt.: ________ City: ____________________________________ State: _______ Zip: _______________ Home Phone: __________________________________________________________________ Affiliations with other sports car clubs: ____________________________________ What do you hope to gain from ISOA Membership? _______________________________ TRIUMPH(s) you currently own: Specific Interests: Model Year Condition Rallye _____ Social Events ____ ___________ _____ ______________________ Slalom _____ Technical _______ ___________ _____ ______________________ Tour _______ ___________ _____ ______________________ Other _________________________ Date: _____________ Signature of Applicant: _________________________________
Annual dues: $30.00 plus a $10.00 per person one-time charge for name tag, etc. Turn in this Membership Application at a monthly meeting, or mail to: Sheri Pyle, 320 N. Linden, Itasca, IL 60143 For more information, contact: Jack Billimack Crystal Lake (815) 459-4721 Ann & Tim Buja Rockford (815) 332-3119 Arlene & Ken Kenzdy Park Ridge (847) 825-8581 Sheri Pyle Itasca (630) 773-4806 Irv Korey Highland Park (847) 831-2809 Unless otherwise announced, Monthly Meetings are held at 7:00pm on the first Sunday of every month at Mack's Golden Pheasant restaurant, 668 W. North Avenue, Elmhurst, Illinois.
Northern Illinois' Oldest, Most Active Triumph Car Club.
Offically Chartered Chapter of The Vintage Triumph Register.