Annual dues - $25.00
     Make checks payable to:
     Badgerland Miata Club

     Seend to:
     Jim Hotz
     S45 W33434 Hengen Drive
     Douseman, WI 53118

Membership Application

Today's Date:

Member Name:

Co-Member Name:

Member name to appear on Badge:

Co- Member name to appear on Badge:


City:    County:    State:     Zip:


E-Mail Address: (Will not be shared outside of Club)

Your Miata - Year: Color License:

More Miata - Year: Color License:

After the form is filled out click the send button and your information will be sent to the Badgerland Miata Club Treasurer. To complete your application send a check to the address at the top of the form or fill in the credit card information below. BMC does not keep credit card information on file.

Membership Fee $25.00