Mar 19, 2011 VA4WDA Annual Meeting & Wheeling Day

[Sandy Schneirla]

Where: Starr Motors, 2584 Pruden Blvd, Suffolk, VA 23434
When: Saturday – March 19, 2011
Time: Wheeling 9 am – 1 pm, Lunch Break, Meeting 2 pm

Please plan to attend both the wheeling and the meeting.
There is no cost to you, but we do need some information.

Name: _____________________________________ Club/Association: _______________________

List additional people attending with you: ________________________________________________

Address: ___________________________________________________________________________

Phone: (______)_______________________ Email: _______________________________________

Emergency Contact Name: ___________________________ Phone #: (____ )___________________

Vehicle Year: __________ Make: ____________ Color: _____________ Tag #: ________________

For questions or concerns, please contact Sandy Schneirla (VA4WDA Member-at-Large) at [phone] or [e-mail]. Please complete this form and email to Sandy at [e-mail] or fax to [phone].