Page 64 of Cougar Parts and Accessories Part 2 by Auto Krafters, Inc.

Application for : New Member Renewal Referred by (How and/or where did you hear of us): __________________________________________________ I hereby apply for membership in the International Mercury Owners association (IMOA) yearly dues are $35.00 U.S. funds for Continental U.S. Canada ($40.00 U.S. Funds elsewhere). Dues paid will automatically give you membership in the regional IMOA in your area (where applicable). Make check payable to: I.M.O.A. and mail with this form to: Jerry Robbin, International Mercury Owners Association, 6445 W. Grand Ave. Chicago, IL 60707-3410 General Information: Name: Occupation: Address____________________________________________________ Date of Birth: _______________________________ City: State: Zip: Phone (Include Area Code): Date: I am: Single Married Other Tell us about the Mercury(s) your own: Year Model VIN Condition Color Kindly enclose with this application: a photo of your Mercury(s), any technical tips you may have to share with our members, ads you would like placed (free of charge to members) or articles you have written so that we may include them in the next edition of our publication, Quicksilver. Kindly fill out the questionnaire on back - The International Mercury Owners Association cordially invites you to join us. The International Mercury Owners Association (IMOA), founded in 1991, was formed for the purpose of offering Mercury owners and collectors (regardless of year or model of vehicle owned) the advantages of locating parts, sharing information, the opportunity to locate or sell cars, and to receive a quarterly publication called Quicksilver. Our goal is to formulate well organized local car shows in addition to an international convention. By becoming a member you will receive the following benefits: Quicksilver a quarterly publication which contains original articles by members, technical tips, photos of membersf cars, classified ads (free non-commercial listings to members), and when available, information on upcoming car shows. Technical Advisors We have a staff of technical advisors throughout the U.S. who will help you with any questions or problems you may have for finding parts or information needed for any restoration project you may have. Mercury Parts Services Directory We publish a yearly directory containing the names, addresses and phone numbers of vendors who carry Mercury parts or render services to Mercury cars. Annual show: We hold an annual show which includes: display of membersf cars with judging for awards; swap meet; car corral; and a banquet. We look forward to your membership and participation in the IMOA. The International Mercury Owners Association Membership Application Please do not send membership application or dues to Auto Krafters, Inc.

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