Chapter/SIG/Region Renewal – Model A Ford Club of America

Chapter/SIG/Region Registration Renewal

MAFCA Policy P3S20 governs the registration procedures for our MAFCA Chapters. This online form is here to help you complete this task in a timely fashion. Please see the policy for full details. Click Here To Download

Purpose. The purpose of this section is to provide guidelines for the annual renewal of MAFCA Chapter registrations. For the purposes of this policy, the term “Chapters” includes MAFCA US and International Chapters, MAFCA Special Interest Groups and MAFCA Regions.
Annual Chapter registration enables MAFCA to have up-to-date Chapter information. It will also facilitate communications to the Chapters, provide accurate information for potential Chapter members, and reduce mailing and administrative costs. MAFCA has instituted a mandatory fee to be determined each year for the provision of General Liability and Directors’ & Officers insurance. Payment of this fee is required for Chapter registration.
Annual Chapter registration runs from January 1 to December 31.

Chapter /Special Interest Group/Region Registration Renewal

Chapter Name(Required)

Enter your Chapter name here.

Chapter Mailing Address(Required)

Address Line 1 Address Line 2 City State / Province / Region Zip Code Country

Designated Contact Information

Designated Contact Name(Required)

Designated Contact Email(Required)

Enter NA for none

Designated Contact Phone(Required)

Enter NA for none

Newsletter Editor

Newsletter Editors Name(Required)

Newsletter Editors Name. Enter NA for none

Email(Required)

Newsletter Editors Email enter NA for none

Name of Chapter Newsletter(Required)

Enter the name of your Chapter Newsletter. Enter NA for none.

Webmaster

Webmaster Name N/A if not applicable(Required)

Webmaster Email N/A if not applicable

Website N/A if not applicable

Membership Info

Total Number Of Members In Your Club(Required)

Please enter a number from 0 to 1000.

Please enter the total number of members in your club.

Does Your Club Require MAFCA Membership Of It's Members(Required)

Yes

Total Number Of MAFCA Members In Your Club

Please enter a number from 1 to 1000.

Please enter the total number of members in your club.

Is The Chapter A Member Of Another Club(Required)

Yes

Other Club Name

Enter the name of any other club affiliation

Club Officers

Please enter the club officers information below

President's Name(Required)

First Last

Enter Your Chapter President's Name

Phone(Required)

Email(Required)

Membership Number(Required)

Enter The MAFCA Membership Number Here

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Secretary

Name(Required)

First Last

Enter The Secretary Name Here

Phone(Required)

Email(Required)

Membership Number(Required)

Enter The MAFCA Membership Number Here

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Treasurer

Name(Required)

First Last

Phone(Required)

Email(Required)

Membership Number(Required)

Enter The MAFCA Membership Number Here

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Officer or Director 1

Name(Required)

First Last

Phone(Required)

Email(Required)

Membership Number(Required)

Enter The MAFCA Membership Number Here

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Officer or Director 2

Name(Required)

First Last

Phone(Required)

Email(Required)

Membership Number(Required)

Enter The MAFCA Membership Number Here

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Special Information

Send A Complimentary Copy Of The Restorer(Required)

Yes

Please send a complimentary copy of The Restorer to our Chapter. Note: If the MAFCA office receives this completed form after January 15th, you must request and include payment of $5.00 to cover postage and handling for the missed issues of the current year. Canada and International must call MAFCA office for exact postage rates

Send A Complimentary President's Pin To the President Listed Above(Required)

Yes

Please send a complimentary President’s Pin to our President listed above. (One pin for President serving multiple terms please).

CAPTCHA

Submitting this form is required to keep your Chapter in good standing with MAFCA.
There is no fee if renewed before February 28th.
Renewal forms postmarked after February 28 must include a Late Fee of $10.00.
Return this form to: MAFCA, 250 South Cypress Street, La Habra, CA 90631-5515.
Questions? Call (562) 697-2712 (10 AM to 4 PM Pacific) or e-mail:
If you prefer to submit by mail you can download P3S20 here.

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Chapter/SIG/Region Registration Renewal

Chapter /Special Interest Group/Region Registration Renewal

Designated Contact Information

Newsletter Editor

Webmaster

Membership Info

Club Officers

Secretary

Treasurer

Officer or Director 1

Officer or Director 2

Special Information