The 14th Annual SHO Club Convention
July 18-21 2005, Track Day: Wed. July 20.
Putnam Park Raceway DRIVER/CAR INFORMATION Form
Fill out this form and FAX or mail with your convention registration.  If you have already sent in your registration, please fill it out and send it in ASAP.  
Fill out the form completely even if you have done it for years!

DRIVER INFORMATION:  List all past competition, school, convention, autocross driving experience including SCCA or other licenses.  Do the same for the second driver in the car also.

DRIVER One NAME: ____________________________________________________
(use the back of the form if you need more room for any section): List experience here:

DRIVER Two NAME:_____________________________________________________
 (if there is one) List experience here:

VEHICLE INFORMATION:  Year: _____________________  ATX or MTX (circle)
List Vehicle modifications to brakes, motor, suspension etc.

TIRE INFORMATION: List the Brand, Model and speed rating of the tires you plan on using at this event.  H rated tires minimum recommended.  2/32" tread depth minimum for street tires.  

CIRCLE THE CLASS YOU WOULD LIKE TO BE IN, we reserve the right to place you in another class to make the best run groups, see track event info for rules for each class:

                 Novice               Touring               Intermediate               Advanced

National Convention #14 is a Prairie Sage Enterprises, Inc. Production
Send form to address below or FAX to: 309-444-8570 (Please confirm FAX by phone or e-mail).