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Registration
Jensen National 2009 West
October 8 – 11, 2009 |
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Name |
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Spouse/Guest |
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Address |
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City |
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State |
Zip |
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Club Affiliation |
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Phone
(day) |
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Phone {eve) |
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Email: |
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Distance traveled
in your Jensen to arrive at |
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All attendees must
be registered and sign the appropriate meet waiver Reserve hotel by
contacting your choice directly |
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Vehicles to be
registered (please enter
VIN number) |
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Jensen Healey |
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Jensen GT |
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Interceptor |
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Interceptor Conv. |
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Other Jensen |
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Jensen Built |
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Event Package Includes: |
Thursday Welcome
Party, Friday Show & Shine, Entrance to |
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Registration |
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Totals |
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Single |
$xxx |
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Couple |
$xxx |
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Additional Person |
$xxx |
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Shirt Order |
$25.00 each |
Please order now,
shirts will not be available for purchase at the event.
Contact us for other sizes |
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Size |
Qty |
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Medium |
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Large |
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XL |
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XXL |
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GRAND TOTAL |
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PLEASE MAKE YOUR CHECK PAYABLE TO THE JENSEN
NATIONAL AND MAIL WITH THIS FORM TO : Steve Brennerman, |
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