APPLICATION TO Join THE
ARKANSAS TIN LIZZIES CLUB
Name_____________________________ Birth date
____________
Spouse name ______________________ Birth date
____________
Address ___________________________________
City _______________________________ Zip ____________
Type of Model T
_________________________________________
Model T club
affiliations____________________________________
Telephone # _______________ e-mail
_______________________
Cell phone # _______________
Other suggestions, or
comments_____________________________
______________________________________________________
______________________________________________________
Our club meets in one of four different zones in Arkansas
four times a year.
Annual membership dues per family: $10.00
Please return this form with your check payable to
“Arkansas Tin Lizzies”
to the following address:
David Ragsdale
216 N. El Paso, Suite A
Russellville, AR 72801
Of If you have any questions you may contact Nellie Howell
at (479)
229-3878 | 
