LAKESHORE MODEL A FORD CLUB
ROCHESTER, NY
MEMBERSHIP APPLICATION

Mail this completed application along with $25.00 annual membership dues payable to Lakeshore Model A Ford Club to the address below.

Lakeshore Model A Ford Club
Attn: Sue Smith 
513 Stony Point Road
Spencerport, NY 14559
Any Questions Please Contact Director Pat Lloyd (585) 509-9044