SEMA Action Network - Auto enthusiasts protecting our hobby

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	Canadian Resident Signup Form

* Required fields

First Name

* Last Name

Title

Club/
Organization

(* if applicable *)

Address

City

Province

Postal Code

Phone

Fax

To receive timely action alerts regarding legislative and regulatory initiatives in your Province, please provide your email address.
The SEMA Action Network will not sell or distribute your E-mail address and will only use it for the purpose of contacting you in regards to the SEMA Action Network and its initiatives.
* E-MAIL
ALTERNATE E-MAIL
CLUB WEBSITE

	How did you hear about the SEMA Action Network?

	Please specify (i.e. name of car club, magazine, internet website/forum, etc…)

	Number of Members in Club:
	Council (# of clubs represented):
	Regional (Provinces represented):
	Estimated number of individuals/enthusiasts to whom you can pass SAN information to:

	How would you classify your club?(check all that apply):

		4x4 / Off-Road
		Antique / Classic
		Custom / Kit / Replicas
		Full Size Truck
		Late Model
		Lowrider
		Mini Truck
		Muscle
		Racing & Performance
		Sport Compact / Tuner
		Street Rod / Hot Rod
		Other

	Biggest annual event(s)/dates of these events/estimated number of attendees?


	Any pending legislative/regulatory issues of concern to your club?


	Any comments/suggestions for SEMA or the SEMA Action Network?



	Questions, comments: Contact Jason Tolleson at 202/783-6007, ext. 39
	by e-mail at jasont@sema.org,
	or by mail at:
		SEMA Action Network 1317 F Street, NW, Suite 500 Washington, DC 20004.