pctc logo
 

Pittsburgh Circle Track Club
Membership Application

   Individual - $20.00      Add a Spouse (for $5) - $25.00 (total)       Family - $30.00 (total)
 
   Name __________________________________________________________________  
 
   Spouse (to add a spouse) __________________________________________________   
 
   Children (for family membership) ____________________________________________
 
   Address ________________________________________________________________
 
   Phone Number __________________________________
 
   E-mail Address __________________________________
 
   _____ Owner     _____ Driver     _____ Pit Crew     _____ Fan

 
   Owners and drivers, please provide the following information:
 
   Car Number ______________       Division ____________________________________   
 
   Home Track _____________________________________________________________
 
   If Owner, Driver's Name____________________________________________________   
 
   If Driver, Owner's Name____________________________________________________   
 


          Please mail your completed membership form and fees to:
 
          Pittsburgh Circle Track Club
          c/o Dave Olivieri
          203 Olde Ingomar Ct.
          Pittsburgh, PA 15237

          Please make checks payable to the Pittsburgh Circle Track Club.


 
Back to main page