Puget Sound Chapter of POCI Membership Information

PUGET SOUND CHAPTER OF
PONTIAC-OAKLAND CLUB INTERNATIONAL

MEMBERSHIP APPLICATION

Owning a Pontiac or Oakland is NOT a requirement of membership.
An interest and appreciation of these fine cars is the only requirement!

PRINT this form and mail with all applicable Dues to:

PSC/POCI
PO Box 5873
Lacey, WA 98509

Membership to the National Chapter of the Pontiac Oakland International is required to be a member of the local chapter.
National Chapter Dues are $31.00 per year. If you are not a member of the National Club, make the check for your National Chapter dues payable to Pontiac Oakland Club International.

Local Chapter Dues are $15.00 per year. Make the check for Local Chapter dues payable to Puget Sound Chapter of POCI. The local chapter has a pro-rated chart for dues based on August as the start of our membership cycle.
Circle the month during which you are making payment in the chart below. The dollar value associated with that month is the amount due to start your membership and get in synch with our annual membership billing cycle.

January $8.75	February $7.50	March $6.25	April $5.00	May $3.75	June $2.50
July $1.25	August $15.00	September $13.75	October $12.50	November $11.25	December $10.00

Member Information

Name ______________________________________________________

Spouse Name (if applicable)_____________________________________

Address ____________________________________________________

City, State, Zip _______________________________________________

Phone _____________________________________________________

E-mail _____________________________________________________

POCI Member number (if already a POCI member) _________________

Vehicles

Vehicles (Year, Model, Body Style)

Pontiac #1 __________________________________________________

Pontiac #2 __________________________________________________

Pontiac #3 __________________________________________________