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A club for "94-96" Impala SS’s, Caprices & 9C1’s                                  MEMBERSHIP APPLICATION Date _____________ Date of Birth _____________ Name (last) ___________________(first) ________________ (Wife/Friend) _____________                                                                                                             --circle one-- Address (street)______________________________________ (unit #_______________) City ______________________________________ (State) ____ (zip)_______________ Phone (home) ( ________________) (cell) _____________________ E-Mail Address _____________________________________________________________ B-Body # 1 (year ________) (model _________________) (color)_______________ B-Body # 2 (year) _______) (model _________________) (color) _______________   Comments and Suggestions: ___________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Membership Dues ___________ $20.00 Per Year (checks payable to:   GOFASST) Contact:    Bob Borchers Pres. &  Membership                Chairman .......  Ph: 321-228-5931   Email: blborchers@bellsouth.net   (If mailing hard copy, send to:)  Terry A. Rodgers, Treasurer 1637 Hempel Ave. Windermere, FL 34786