JSCA GASOLINE ALLEY NATIONALS
OFFICIAL REGISTRATION FORM


Driver Name _____________________________ Class______________________

Address ________________________________ Phone # ___________________

City ____________________________ State ___________ Zip ______________



FOR OFFICIAL USE ONLY

Pill #________________ Pill #________________



ANNOUNCEMENT CARD
(Please print clearly)
Name ______________________________________ Age _____________

City _____________________________________ State ________________

Chassis Make _____________________________ Year _________________

Engine Make ______________________________ Class ________________

Sponsor (s) _____________________________________________________

Favorite Racecar Driver ____________________________________________

Career Highlights _________________________________________________


Please return Registration & Announcement Card Along with check to:
JSCA
409 Munroe Falls Road Tallmadge, OH 44278 (330) 798-7744 (330) 798-9611