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Event Management & Marketing, PO Box 21311, Columbus, OH 43221 / Ph: 614-268-1181 / Mon-Fri 10am-5pm
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Jeff Johnson Motorsports LLC
Registration for NNPSA Membership
We offer two ways to register:
Use the On Line Registration Form Below
print the form below, fill out and mail to:
Jeff Johnson Motorsports, PO Box 21311, Columbus, OH 43221
On Line Registration for NNPSA Membership
Contact Information:
Address 1:
Address 2:
State:   Zip:
Email address:

Select Membership:
Active membership - $50.00
T-shirt size: Sm Med Lg XL
Active membership renewal - $15.00
Supporting membership - $15.00
Quantity additional decals - $5.00 ea
Professional membership - Free
Track Operator Press
Fabricator/Builder Former Driver/Owner

Vehicle you are registering:
Year: Make: Model:
Chassis: Back Half Tube Outlaw/Top Sportsman
Was your car raced originally? Yes No
If yes, in which categories:
Pro Stock Altered Gas Modified Production
Original driver
Years Raced
Sanctioning Body
Are you converting an existing race car to Nostalgia Pro Stock trim?
Yes No
Are you building a Nostalgia Pro Stock from scratch? Yes No
Is your car finished? Yes No - If not when?
Are you interested in racing or showing your car?
Race Show Unsure
Assuming there are events within a reasonable distance of you, do you anticipate participating this year?
Yes No - If not when?
All contact information will remain confidential.

Additional Comments:

Payment Information
Send me a PayPal invoice

Type of payment: Credit/Debit Card
Type:    VISA     MasterCard

Card Number:
Expiration Date:
(eg. 06/19)

If you would prefer, you may print this page and mail to:
PO Box 21311, Columbus, OH 43221

Thank You!
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