Schuman's Speed Center Exclusive VIP Membership:

Please provide the following registration information:

Name
Address
City
State
Zip
Title, Coaching Position, or Sport Position
Organization, High School, or College
Age
Grade
Work Phone
Home Phone
Primary Sport	Football Basketball Soccer Field Hockey Track and Field Softball Baseball Hockey Volleyball Lacrosse
Secondary Sport	Football Basketball Soccer Field Hockey Track and Field Softball Baseball Hockey Volleyball Lacrosse
Sport interested in developing speed for:	Football Basketball Soccer Field Hockey Track and Field Softball Baseball Hockey Volleyball Lacrosse
E-mail (MANDATORY)

Please provide choose the Shirt Order  that best suits you:

# of Memberships	Speed Membership
Insert comments for quantity orders or the names of people you are signing up if different from above.
Payment Information
. If you want to pay by check please send check to: Schuman's Speed Center, 49 Finnigan Ave. Q-3, Saddle Brook, NJ 07663
Type:	Visa Mastercard	Credit Card #
Name On Card
Address
Expiration Date	Month: January February March April May June July August September October November December Year: 2003 2004 2005 2006 2007 2008 2009 2010
Pay Full Amount

You can fill out this form and mail your check for the appropriate amount to: Schuman's Speed Center, 49 Finnigan Ave. Suite Q-3, Saddle Brook, NJ 07663. Call 201-587-0965 if you would like to order by the phone!

Questions? Call us at 201-587-0965 or email us at schumanspeed@aol.com