Sample Petition for New Chapter Date Mailing Address City State Zip-Code Board of Directors Model A Ford Club of America, Inc. 250 South Cypress La Habra CA 90631-5515 Board Members: We, the undersigned, do hereby petition the Board of Directors of the Model A Ford Club of America for recognition as a chapter, and request that a charter be issued authorizing us to conduct activities in the County of ________________________, State of ____________________ under the name_____________________________________________________ We agree to conduct the business of our chapter in a manner that will abide by the aims and purposes of the Model A Ford Club or America as stated in Article II of the National by-laws. Respectfully, Name Address Signature (Print or Type) (Print or Type) ____________________ ______________________________ ______________________ ____________________ ______________________________ ______________________ ____________________ ______________________________ ______________________ ____________________ ______________________________ ______________________ ____________________ ______________________________ ______________________ (Note: A Minimum of five National members is required)