Page 60 of Cougar Parts and Accessories Part 2 by Auto Krafters, Inc.

Auto Krafters, Inc. Gold Card Club q 1 year membership $49.95 q 2 year membership $79.95 name: address: ______________________________________________________________________ City: State: zip: _____________ Daytime phone number: Fax number: _______________________ Evening phone number: Email: ____________________________ year and Type of vehicle: _______________________________________________________ please charge my credit card q $49.95 for one year q $79.95 for two years Specify: q VISA q MasterCard q Discover q Am Ex Credit Card #: Expiration Date: ___________________ print name on card: __________________________________ Signature of card holder: ______________________________ I am enclosing: q $49.95 for one year q $79.95 for two years q Cash q Check q Money Order Please enclose payment and mail to: Your membership card will be sent to you in the mail. Satisfaction guaranteed. If you feel this program is not for you, simply notify us in writing within 60 days. We will refund your membership fee minus any discounts already given. auto krafters, inc. pO box 1100, new market, va 22844 DETACH FORM HERE 10% Discount Free Shipping See details on back For the Classic Ford Enthusiast

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