Driver   E-mail Address     Car No.
Car Owner     Hometrack
Street Address  Hometown
State   Zip Home Phone  Work Phone
*S.S #(Driver)    Check Paid To (Circle)  Driver     Owner

Car Owner   E-mail Address    
*S.S #(Owner)   Street Address  
Hometown     State   Zip

Body   Year Chassis  
Engine Builder    Type:   Circle One:   9:1 Aluminum      ACE         Iron Head   
Shocks   Wheels  Brakes  

Primary Sponsor
Associate Sponsors

 

In order for your membership to be recorded in Wisconsin Challenge Series records, payment in the amount of $40 must be submitted to:  Wisconsin Challenge Series    209 N. Outagamie St.   Appleton, WI   54914

 

Memberships filed electronically are accepted with payment within two weeks of submission.