Membership Application Membership Application Spam protection, skip this field Name Significant Other (optional) Home Address Cell Phone Email john@gmail.com Emergency Contact Name, Relationship & Number Miata Year Miata Color Personal License Plate (optional) Or for online payment options, Venmo or PayPal please email Barb Or, You can send your Dues Payment with your name and memo for Annual Dues to: Les Bois Miata Club P O Box 6845 Boise ID 83707-0845
