2008 Five Mile Point Speedway Car Number Registration Request and Media Sheet

Driver Name:____________________________________________________________________

Hometown:______________________________________________________________________

Division:________________________________________________________________________

*Car Number Requested: 1st choice _________ 2nd choice _________ 3rd choice _________

Figure 8 Teams only: Are you requesting a Nextel Cup paint scheme? (yes)__ (no)__

E-Mail Address:_________________________________________________________________

Driver Website: _________________________________________________________________

Phone Numbers: (day)_____________________ (eve.)______________________

Driver Information: (not required, for announcer use only)

Age:__________ Family:___________________________________________________________

Nickname(if any):_________________________________ Number of years racing:_____________

Driver Sponsors:__________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

Driver Achievements:______________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

Would you like you website linked to the fmp and/or rocdirt website?_________________________
(we ask that you include fmp or rocdirt related information on your site in return)

Please return this form to: Five Mile Point Speedway- PO Box 54 - Kirkwood, NY 13795
Or fax the form to 607-775-3417.

Please forward any driver cards, team photos, press kits or any other information that can help us to better promote your team efforts.

*note - car numbers are awarded based on previous membership, participation and first 2008 paid membership applications.