Application

2012 MOVR Membership Application

MOVR dues and member applications are required to be eligible for any awards given at the end of the season. Points will begin accumulation only after membership dues are received by club president. MOVR dues for the 2012 season are $40.00 per car. MOVR membership packet includes: One Free MOVR T-Shirt, Free Car Entry and One Free Pit Pass to each MOVR race.

Driver Name: *
Address: *
City, State, Zip: *
Phone Number: *
Email:
Car Year / Make / Model:
Car Number:
Number of Years I Have Raced:
Years I Have Raced with MOVR:
Where I Have Raced:
Classes I Have Raced:
Anything and everything you would like for people to know about you:
By hitting the Submit button below, the information you entered above will be automatically submitted to us. Please don't forget to mail Membership Dues ($40) to 4495 Utah Rd, Wellsville, KS 66092. Please also include a picture of your car and any other pictures you would like to be displayed on our website.