CAROLINA CORVETTES

APPLICATION FOR MEMBERSHIP

Fill out this form and the NCCC application form (link below) and bring them to the next club meeting.

Date: __________________________

Name: ___________________________________________________________________

Spouse/Companion: _______________________________________________________

Address: _________________________________________________________________

City: ________________________________________State: _____ Zip; ______________

Home Phone: (_____) _____ - ________        Mobile Phone: (_____) _____ - ________

Home E-Mail Address:   ____________________________________________________

Work E-Mail Address:  _____________________________________________________

Birthday (dd/mm)         Primary:  ___/____    SpouseCompanion:  ______/______

Your Vette:   ______    ____________________    ________     __ Coupe    __ Conv.

                    Year               Color                         Model

 

 Primary

 Spouse/Companion

Club Initiation Fee ( one time only)

$10

$5

Club Dues ( $5 per month + $2 for Spouse)

            (Annual Dues $60 +$24 for Spouse)

_____

_____

National Council of Corvette Clubs (NCCC)

            Initiation Fee

            Annual Dues

 

$10

$25

 

N/A

$10

                (NCCC New Member =$35+$10 Spouse)

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                                                Grand Total

MAKE CHECK PAYABLE TO CAROLINA CORVETTES

NCCC Membership Application  Here