<p> 2016 MEMBERSHIP APPLICATION Thumb Tractor Pulling Association Inc. 4004 Forester Road, Deckerville MI 48427 810-537-1137 ALL MEMBERSHIPS ARE NON-REFUNDABLE ______Membership Dues Are: $95.00 Before December 31, 2015 $150.00 After January 1, 2016 to July 15, 2016 ______</p><p>Please Print Cell Phone ______/______/______</p><p>Name ______Phone Number ______/______/______</p><p>Address ______City ______Zip ______</p><p>Drivers License # ______SS #last four digits______</p><p>Birthdate ______E-Mail Address______</p><p>Model ______Year ______Engine ______</p><p>Cubic in. ______HP - Optional ______In Case of Emergency # ______/______/______</p><p>Name of Spouse or Contact Name ______</p><p>I hereby state that all above information is accurate and truthful. I understand that any false information that I have given will forfeit my paid dues for the year, and the TTPA will enforce their General Rules of disqualification. This applies for the TTPA pulling season of 2016. Member Sign Name______Date ______Please Circle Class You Will Be Pulling In: 5500 V-8 Hot Rod 8000 Diesel Pro Stock 6200 Pro Street Pickups 6000 Farm 9300 Super Farm 6200 SS Pickup 10 Farm 12,000 Open Farm Hot Diesel Pickups 6500 Modified Tractor Street Legal Pickups 2.5/2.6 Diesel Pickups ______Information for Announcer:</p><p>Spouse: ______Number of Years Married: ______</p><p>Number of Children and Age: ______</p><p>Occupation: ______</p><p>Number of Years Pulling, Points Championships and Years: ______</p><p>Hobbies: ______</p><p>Sponsors: ______Assistant Driver $25.00 ALL MEMBERSHIPS ARE NON-REFUNDABLE This will be paid for each Assistant Driver you have, and must be paid before the Assistant Driver can compete with your vehicle. If not, you will be disqualified.</p><p>Name ______Phone Number ______/______/______</p><p>Cell Phone # ______/______/______</p><p>Address ______City______Zip______</p><p>Drivers License # ______SS # last four digits______</p><p>Birthdate ______E-Mail Address______</p><p>In Case of Emergency - Phone Number & Name ______</p><p>______I hereby state that all above information is accurate and truthful. I understand that any false information that I have given will forfeit my paid dues for the year, and the TTPA will enforce their General Rules of disqualification. This applies for the TTPA pulling season of 2016. Assistant Sign Name ______Date______</p>