Williams/PITL ProSlalom - July 28, 2007 You can fill-out, print and bring this form with you to the open house, first event or mail with your payment to: PITL - 3327 Charmaine Heights - Mississauga, ON - L5A 3C2 Please make cheques payable to: MSOC

ProSlalom Event

Driver Information
Name	Phone ()
Address
Email How did you hear about our PITL Series?	I have 3 or more autoslalom events experience (this is mandatory)
Car Information
Year	Make
Model	Colour
Displacement	Tire Brand
Modifications
Club Use Series Class Series Comp No   Reg'n Fee Paid Info Verified Y N Series Prepaid

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