Jeep Expeditions
P.O. Box 5324
Mesa, AZ 85211
www.jeepexpeditions.org
New Member Sign-Up
Member Information
Fill in the information below to join the #1 Jeep Exclusive Expeditions club in the US.
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Last Name
M.I.
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First Name
Date of Birth
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Month
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Day
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Year
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Address 1
Address 2
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City
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State
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Zip Code
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Cell Phone Number
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Email Address
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Year
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Model (Wrangler, CJ, Cherokee, etc)
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Color
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License Plate #
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State Registered In
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I maintain Liability Insurance on my Jeep
Yes
No
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Is your Jeep modified and if so tell us about the modifications (lift kit, winch, lockers, tire size, etc)
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CB Radio ?
Yes
No
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I have a CB "Handle"
Yes
No
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CB Handle
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HAM Radio ?
Yes
No
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Ham Call Sign
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Have you registered for our Members Only Forum ?
Yes
No
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What is the name you will be usine on the Members Only Forum ?
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Annual Dues are $40 per year, how will you be paying your membership dues ?
I will mail a check to the above address
Pay Pal to "Payments@JeepExpeditions.org"
Please review Terms and Conditions of Membership
Terms and Conditions (read all 5 sections):
www.jeepexpeditions.org/Forums/index.php?board=124.0
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I have read and agree to the terms and conditions.
Yes
No
Don't Forget to:
Pay Dues via PayPal: www.jeepexpeditions.org/membership_dues.php
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By sending a check to: Jeep Expeditions, P.O. Box 5324, Mesa, AZ 85211
Please email 2 pictures of your Jeep to "membership@jeepexpeditions.org"
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