2010 Mid-Missouri Truck and Tractor

Pulling Association

Membership Form

 

Name_____________________ Address___________________

City________________ State__________ Zip___________

Home Phone____________________

Cell Phone______________________

E-mail Address______________________________

SSN____________________

 

Vehicle Info:

 

Year_________

Make______________

Model_______________

Classes Pulled_______________________________________

 

Signing this membership form you are agreeing to follow and obey MMTTPA Rules and Regulations.

 

Signature of Owner________________________Date_________

 

Primary Membership $100.00___________

Associate Membership $50.00__________

 

Please Mail Membership Form along with Money to:

Ronnie Albertson

72 Catfish Rd.

Tuscumbia Mo, 65082