SUPER LITE PRO SERIES

Application to Board of Directors for Competitor License

This form needs to be returned with the membership application to the Board of Directors


Date:___________________________________________


Requested division:_______________________________

Name of driver:__________________________________

Age:____        Birthdate:____________________

Address of driver:________________________________
                            
                            _________________________________

Phone number of driver:___________________________

Car owner(s) name:_______________________________
 
Address of owner:_________________________________ 

                                __________________________________

Phone number of owner:____________________________
 


The information in yellow will be used for Public Announcement purposes.  Be honest and give as much info as you feel relevant.

Driver info: Previous racing experience: YES NO

If yes, please explain below, ie. years, divisions, tracks, any special awards, etc.
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________


 

OFFICE USE ONLY: GRANTED__________________ DENIED______________________
DATE:____________________