USER NAME*

PASSWORD*

VERIFY PASSWORD*

Driver # 1   First Name* Last Name* Address Line 1* Address Line 2 City* State*  Missouri  Illinois  Other  Country ZIP5* E-mail Address* Home Phone Work Phone Car Phone Birthday Occupation Hobbies/Interests	Driver # 2   First Name Last Name Address Line 1 Address Line 2 City State  Missouri  Illinois  Other  Country ZIP5 E-mail Address Home Phone Work Phone Car Phone Birthday Occupation Hobbies/Interests
CLUB and WEBSITE OPTIONS
I would like to receive a Printed Miata-File. By default every member receives a printed copy of the "Miata-File" newsletter by mail each month. However you can choose to use the online version of the Miata-File newsletter exclusively. This saves the club the expense of printing and postage.	Uncheck this box to use the online newsletter and not receive a printed copy.
Please include me on email information and announcements. By default each member receives email announcements sent by club officers. We encourage you to leave this option checked. These informational emails include event changes and cancellation notices.	Uncheck this box to remove your email address from officer email announcements.
Please include me in the online member directory. By default each member appears in the online member directory in the Members Only section. This information is only visible to members who have paid their dues. Posting your information helps other members find your email, phone number, see your photos and generally helps members become acquianted.	Uncheck this box to not have your information appear in the online directory.
About your Miata...
Year
Color
Date Purchased
Package
Vanity Plate?
Options and/or accessories you have added:
What do you plan to add if (when) your ship comes in?
What other sports cars have you owned?
How often do you drive your Miata?
Longest trip taken to date?
What kind of activities would you like to see the Club become involved in?