Application for Membership Horseless Carriage Club of America "Nickel-Era" Register To join the Nickel-Era Register: Print this form. Complete the form offline. Draft a Check or Money Order for $10.00 U.S Funds or $15.00 U.S. Funds (Foreign membership) to HCCA Nickel Touring Register:  Mail to:   John Manifor,  1643 Agave Ave. La Habra, CA 90631 (562) 697-2075 Name of Applicant ____________________________Spouse _____________   Street Address ____________________   City                 _____________________    State___    Zip_________   Telephone (      )  ___________________     Email:  ______________________   Required:  Current HCCA Membership # _______ or Life HCCA member#_______ Membership in HCCA must be maintained yearly to belong to the HCCA Nickel Touring Register Primary Nickel automobile(s) used for membership purposes: Please include photo with application Year ___    Make ___________ # of cyl ____ Body Style _______ Year ___    Make ___________ # of cyl ____ Body Style _______ Other Original or Restored-Nickel Era Automobiles owned that would be used for touring with this register.  Photos are appreciated but optional   Year ___    Make ___________ # of cyl ____ Body Style _______ Year ___    Make ___________ # of cyl ____ Body Style _______ Year ___    Make ___________ # of cyl ____ Body Style _______ Year ___    Make ___________ # of cyl ____ Body Style _______ By signing this application, you agree to abide by all rules of the Horseless Carriage Club of America and the Nickel Era Touring Register including maintaining your National HCCA membership and maintaining required liability insurance on your automobiles used for touring.   Signed ________________________________________   Date___________________   Submit photo or photos of car(s)  with application.   If you have any questions, Send EMAIL to the   Return to Top of Page