Please copy, fill out and bring to a meeting with your annual dues of $20.00

A club for the owners of the only true American made sports car.

APPLICATION FORM

Name of Applicant____________________________________

Address ________________________________ZIP_________

Telephone #_________________________________________

E-mail Address_______________________________________

Year of Corvette_________Coupe/Conv___________________

Color of Car_________________________________________

Married (  ) Single (  )

Applicant’s Date of Birth Month ____Day___

Spouse/friend Name _________________________,DOB Month ____Day____

If married, Anniversary Date____________________________

Annual Membership is $20.00/car (At this time)

Application Date__________

Please print, Fill out and bring to a meeting with your annual dues of $20.00