VSA Registration and Renewal Form

   If you wish to join VSA or renew your VSA membership, please fill out, print, and mail this form. Please enclose your check or money order, made out to VSA and send it to:
Martin Kern
VSA Membership Chairman
PO Box 352
Fairless Hills PA
19030-0352

                         

   
              LAST NAME:      
             FIRST NAME:      
      KEY# (if renewal):      
                ADDRESS:      
                   CITY:      
                  STATE:      
                COUNTRY:      
          ZIP/POST CODE:      
     VOLVO MODELS OWNED:      
            CHASSIS NO.:      
              TELEPHONE:      
            YOUR E-MAIL: