MUSKINGUM COUNTY SPEEDWAY

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MUSKINGUM COUNTY SPEEDWAY

ZANESVILLE, OHIO

PRESENTS

The

3^rd Annual

STREET STOCK WORLD CHAMPIONSHIP ®

100 LAP FEATURE!!

26 CAR STARTING FIELD

SEPT. 26^th 27^th 28^th

Rain Date Sunday Sept. 29^th

OFFICAL SSWC CAR ENTRY FORM

LIMIT: One registered car per driver.

PRE-ENTRY FEE $50.00

⁽Must be postmarked by Sept 1^st)

ENTRY FEE AFTER AUG.1^st $150.00

ENTRY FEE at the GATE $200.00

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Mail with Payment To:

American Payroll Advance

^{6247 Ashland Rd, Wooster OH. 44691}

DRIVERS NAME______________________ SOCIAL SECURITY #__________________

STREET_____________________________ CAR NUMBER_______________________

CITY____________________ZIP___________ PHONE NUMBER______________________

E-MAIL ADDRESS____________________ MAJOR SPONSOR_____________________

12/10/2001