|
RIVER CITY CORVETTE MEMBERSHIP APPLICATION |
|
Name _________________________________ Spouse / Other __________________________ |
| Birthdate_______________________________ Birthdate_______________________________ |
| Address_______________________________________________________________________ |
| _______________________________________________________________________ |
| Phone ( ) _________________________ Work ( ) _____________________________ |
| Ok to Call? Yes __ No __ |
| Email :_____________________________Best Time to Call_____________________________ |
| 1. Corvette Year : __________ Model __________________ Color ______________ |
| License Number: ___________________ |
| 2. Corvette Year : __________ Model ___________________ Color ______________ |
| License Number: ___________________ |
| Insurance Carrier:______________________________________________________________ |
| Your Occupation _______________________________________________________________ |
| Spouse / Other's Occuapation_____________________________________________________ |
| How did you hear about the club? ________________________________________________ |
| _______________________________________________________________________________ |
|
For Club Use Only
|
| 1st. Event ___________________________________Date:_____________________ |
| 2nd. Event ___________________________________Date:_____________________ |
| 3rd. Event ___________________________________Date:_____________________ |
| Voted as a Member of RCCC:______________Date:_______________Paid:____________ |
|
Fill out and print the application, then bring to a meeting |
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Last Updated:
September 30, 2004
Webmaster: Roger Aylstock
