Register

2009 NeSmith Late Model Series Driver/Owner Information Sheet and Membership Form

Car Info:

Car Number

Car Colors

Primary Sponsor

Secondary Sponsors

Chassis

Engine Model

Home Track

Crew Info:

Crew Chief

Crew Members

1099 Info:

Recipient

ID# (Tax ID or SSN or Recipient)

Driver Info:

Full Name

Drivers ID (Driver\'s License or SSN of Recipient)

Address 1

Address 2

City

State

Zip Code

Daytime Phone

Evening Phone

Cell Phone

Fax Number

Email Address

Website Address

Daytime Phone

Racing Resume (Years Racing, Type(s) of Cars Raced, Championships, Etc.)

Car Owner Info:

Full Name

Address 1

Address 2

City

State

Zip Code

Daytime Phone

Evening Phone

Cell Phone

Fax Number

Email Address

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MEMBERSHIP FEE

Only NeSmith Dirt Late Model Series members will be eligible for points and contingency awards for both the NeSmith Dirt

Late Model Series National Tour, and the NeSmith Weekly Racing Series.

The one-time Membership Fee of $100.00 will enable a competitor to be eligible for points and contingency awards at any

NeSmith Dirt Late Model Series National event, and/or at any NeSmith Weekly Racing Series track.

You can send a check or money order payable to Crate Racin’ USA.

Crate Racin’ USA
P.O. Box 1346
Cartersville, GA 30120