Piquette T ONLY Membership

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Thank you for deciding to join the Piquette Ts.   

Please fill in the form below so that we can add you to our membership roster.  You will then be returned to this page where you can pay your $15.00 dues securely by using a credit card or PayPal account.

Click the donate button to join the Piquette Ts. 
$15.00

Be sure to fill out the form below after paying your dues.
 
Fields with an * are required

* Are you a new member?new
Returning (Enter First, Last Name, and Phone # below, other form items do not need to be completed unless they have changed in the last year)
*First Name
*Last Name
Spouse's Name
Other family members
E-Mail:
*Street
*City
*State
*Zip Code
Home Phone
Work Phone
Cell Phone
Are you a MTFCA Member?Yes
No
MTFCA Member Number
Are you a MTFCI Member?Yes
No
MTFCI Member Number
Occupation
Vehicles you own
How did you hear about us?
Do you have any comments or areas that you would be willing to help with?