NATIONAL NOSTALGIC NOVA

YES!!! I want to join the most responsive and fastest growing Nova club in the world, dedicated to the preservation, history and fun of the '62-'79 Chevy II Nova.

DATE		PRINT THIS FORM AND MAIL OR FAX IT TO: NATIONAL NOSTALGIC NOVA PO BOX 2344 YORK, PA 17405 FAX (717) 252-1666 OR CALL US AT (717) 252-4192 OR (717) 252-2383 TO JOIN OVER THE PHONE WITH A CREDIT CARD
NAME
ADDRESS
CITY
STATE
ZIP
PHONE
NOVAS OWNED
VISA, MC, DISCOVER
EXP. DATE
SIGNATURE

Please circle:

Third Class mail $30.00

First Class mail $40.00

Air Mail $40.00 US funds for Canada

Overseas $50.00 US funds

You can receive a fast issue for $2.00 extra.

Please specify.