Comet Central Membership Application
We invite you to join Comet Central Car Club. Ownership of a Mercury Comet is not required. If you have any questions you may email us at Info@CometCentral.com Thanks for coming on board! Currently we are not charging any membership fees, in the future, if the need arises, we may start charging a fee.
All information in this form is strictly confidential and used only for the Comet Central Membership Database it will not be sold or redistributed.

- Info About Yourself -


You MUST be over 13 years old to join Comet Central. Check this box to confirm.

First Name

Last Name

Address

City State Other State

Zip Code Country

e-mail address Telephone Number

Comet Performance Forum Username

Some Optional Information This information is not required for membership

WebSite Shirt Size
Age Occupation

What is the primary benefit you would like from your Comet Central Club Membership;
Shows&Events Parts Socializing Judged Events Newsletter Racing
Charity Fund Raising Vendor Discounts Comet Advocate Shirts&Hats Other
Based on your selections above, what do you feel would be a fair annual membership fee? $

- Info About Your Comets -


Comet #1

Year Body Style SubModel Other
Engine Transmission
List Any Other Options, Modifications & Info About Your Comet:


Comet #2

Year Body Style SubModel Other
Engine Transmission
List Any Other Options, Modifications & Info About Your Comet:


Comet #3

Year Body Style SubModel Other
Engine Transmission
List Any Other Options, Modifications & Info About Your Comet:


Comet #4

Year Body Style SubModel Other
Engine Transmission
List Any Other Options, Modifications & Info About Your Comet:


Other Comments & Questions? Please Enter them Below:

       

2003 The Central North American Mercury Comet Club