Welcome to Jimmie Johnson.Net!

Please print the application, fill out completely and
fax to (704) 454-7210 or
mail with payment made payable to :
Jimmie Johnson Fan Club
PO Box 5599
Concord, NC 28027
JIMMIE JOHNSON FAN CLUB APPLICATION

Name(s): ___________________________________________________________________________________

Address ( Street address, please. UPS cannot deliver to PO boxes):

Street Address______________________________________________________________________________

City : ____________________________________ State: __________________ Zip Code: ________________
Daytime phone number: _____________________________________________________________________

Email address (Note: this will enable us to keep you updated on a regular basis):

___________________________________________________________________________________________

 
Single membership $19.95 per year + $5 shipping and handling
 
Family membership $24.95 per year + $5 shipping and handling
- up to 4 members in the same household
Memberships Run From One Year Of The Start Date Allow 4 to 6 Weeks Delivery.

You will receive .... Fan Club Logo Note Pad, Fan Club Logo Jumbo Ink Pen, Fan Club Logo Bumper Strip, Fan Club Logo Acrylic Keyring, Fan Club Logo 3" Round Decal, Certificate, Membership Card, Driver Postcard,Newsletters,
A Jimmie Johnson T shirt Large
 
or
Extra-Large
 
and Much More....
Payment method:
 
Check
 
Visa
 
Discover
 
Money Order
 
Mastercard  
Credit Card #: ______________________________________________________________________________
Expiration Date: ____________________________________________________________________________
You may fax your credit card orders to (704) 454-7210
"For office use only"
Member number ______________________________________________________________________
Date joined ___________________________________________________________________________