BACK to the LITTLE INDIANS Website

LITTLE INDIANS CHAPTER OF POCI MEMBERSHIP APPLICATION
(Please fill this form out completely, print and mail to the address below)

Vehicle 1  Description

YEAR
:

PONTIAC
OAKLAND

MODEL:

NUMBER OF CYLINDERS

ENGINE SIZE    
Vehicle 2  Description

YEAR
:

PONTIAC         
OAKLAND

MODEL:

NUMBER OF CYLINDERS

ENGINE SIZE    


Owner Information

Name:     POCI ID#:    *Check here if recently applied to POCI and do not yet have issued ID# 

Street Address: 


City: 
  State:    Zip Code: 

Phone with Area Code: 

E-Mail Address: 

Birthday:


HOW DID YOU HEAR OF OUR CLUB?

SIGNATURE:___________________________________________________


ANNUAL U.S. MEMBERSHIP FEES: 
$15.00
ANNUAL INTERNATIONAL MEMBERSHIP FEES:  $22.00

MEMBERSHIP IN THE PONTIAC OAKLAND CLUB INTERNATIONAL REQUIRED.
THE LITTLE INDIANS IS A NON-REGIONAL CHAPTER OF THE NATIONAL CLUB.

SEND TO:
LITTLE INDIANS CHAPTER OF POCI
c/o KEITH BAKER, TREASURER
P.O. Box 170, Pulaski, WI 54162



Further information is available by contacting the chapter’s
President, Greg Walters or Membership Coordinator, Keith Baker.
The Little Indians Chapter sponsors events, tours, family get togethers, car shows, etc.
Suggestions from members are always welcome and member participation is the strength of the Club.


 
BACK to the LITTLE INDIANS Website