Route 66 Association of Illinois Membership Application

Name: _____________________________________________________      

Address: ___________________________________________________

City: ____________________ State: _______ Zip Code: ___________

Illinois County (if applicable): _________________________________

Phone: ____________________ E-Mail: ________________________                    

Interests in Route 66: ________________________________________

How I can help: ____________________________________________

 Annual Dues:   

General: $15     Family: $25     Business: $30     Foreign: $35     Lifetime: $200

U.S. funds only, please. $10 fee for returned checks.

Membership runs May 1 - April 30

Send to: 

Membership

Route 66 Assn. of Illinois 

2743 Veterans Pkwy., Room 166

Springfield, IL 62704 

Send address changes and questions to Membership at the address above.

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