Electric Auto Association (EAA)
                                  Membership Application

New Member: ________  	   USA: ________           Note: EAA membership dues are
   Renewal: ________	Canada: ________	         tax deductible in the USA
                 Other Country: ________		 as allowed by the IRS.

Date: ____/____/____
  Name: _________________________________   Company: _______________________________
Street: _________________________________     Phone: Hm-_____________ Wk-___________
  City: _________________________________       Fax: _______________________________
 State: ______________  Zip: ____________   Country: _______________________________

If a new members, where did you hear about the EAA ? _______________________________
EAA Chapter you attend or support: _____Sacramento__________________________________
I need chapter information: _________

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        Membership / Vehicle Information  --  Please complete if new or changed
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Please identify your primary areas of interest relating to the EAA.
(Please rank your choices with a "1" being most important, "2" second, etc.)

    1: _____ Hobby / Builder
    2: _____ Professional (EVs are a source of income for you)
    3: _____ Competition (Rallies, Races, and Records)
    4: _____ Environmental and Government Regulations for EVs
    5: _____ Social (Rallies, Shows, Dinners, Other)
    6: _____ New Technology and Research
    7: _____ Promotion and Public Awareness of EVs
    8: _____ Student or General Interest
    9: _____ Electrathon / Bicycle / Off-road Vehicles
   10: _____ Owner / Driver of Electric Commute Vehicle
   11: _____ Other: Please Specify: ________________________________________________

Number of EVs you ever owned ?: __________
Number of EVs you now own ?: _________

Please describe any Electric Vehicles you now own or are building:
(if more than one, attach information on each)

Vehicle Lic#: ______________   State: ____________  Country: _______________________
Vehicle Type: ______________  Make/Model: _________/__________  Model Year: ________
Converted Yr: ______________  Number of Wheels: __________  Motor Type: ____________
Controller Type: ___________  Batteries: No./Type: ____/_________  % Completed:_____
Pack Voltage: ______________  Avg. EV Mi./Week: ________  Avg. EV Trips/Week: ______
Other Features: ____________________________________________________________________
Comments: __________________________________________________________________________
          __________________________________________________________________________

Please make your check or money order for $39 ($45 International)(US funds only) 
payable to the Electric Auto Association.  Fasten it to this form and mail it to -

                            Electric Auto Association
                            2710 St. Giles Lane
                            Mountain View, CA. 94040  USA

Note: All information and statistices in this application are for the exclusive 
use of the EAA.  This form was printed from The Sacramento EV Association HomePage 
located at http://saccityweb.com/seva/index.html