Screen Shot 2017-12-23 at 3.06.16 PM.png
 

HISTORIC MOTOR SPORTS ASSOCIATION 2029 Verdugo Blvd. #1010, Montrose, CA 91020

Member Name *
Member Name
Front Make/Model: Size/Rating (VR, SR, L) Tread Width:
Front Make/Model: Size/Rating (VR, SR, L) Tread Width:
Date to be used as the “POINT IN TIME” to which this car is restored:
Date to be used as the “POINT IN TIME” to which this car is restored:
Roll Bar Installed by you/previous owner/other:If the answer is NO, explain: