Tri-state Hart-Parr Oliver Collectors Association membership form.  Just simply print this page and mail it to our address with a check or M.O. to the:

T.S.H.P.O.C.A

P.O. Box 353

Zelienople, Pa 16063

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If you are experiencing difficulty prinitng this page.  Copy the form and go to file, print.  When the print page comes up you want to click on the print selection only option vs. print the whole page.Then click print. If this does not work out for you please email the webmaster and he will send you a generic form via email.  sawyer2255@yahoo.com

We hope you will enjoy our club!

Membership form

Name:____________________________________________________________

Street Address______________________________________________________

City_________________________State________________Zip______________

Home Phone:_______________________

Cell Phone_________________________

Email_____________________________

Your membership to the club includes insurance from EDGE&TA which is a 2 million dollar liability insurance with our club.  This is a nice addition to all members displaying their tractor at our show or anywhere they go.  Our policy is to ensure equal opportunities without regard to race, color, religion, gender, age , or disability.  Our club does hold the right and authority to revoke your membership and prompt you to leave our club should any matter get out of hand.  The Oliver club is a fun club to all who gather and enjoy the company of another fellow Hart-Parr Oliver enthusiast.  By signing to these agreements you submit to pay the $18 membership and join our Oliver club for one year.

Name(print)____________________Date______________

Signature______________________

Signature of Membership secretary

______________________________Date______________

Membership Number_________________

Tri-State Hart– Parr Oliver Collectors Association

www.tri-stateoliverclub.com

T.S.H.P.O.C.A. 2010