KlasAct Corvette Club Membership Application

Dues - $100.00 annually (Renewable each January for returning members $75.00) New Members: Join between January and June - $100.00 Join between July -September - $50.00 Join between October - December - Cost of Uniform

Today's Date________________________________________ Name _______________________________________________________ Address______________________________________________________ City/state/zipcode_______________________________________________ Birthday_______________________________________________________ Home #_______________________________________________________ Cell #_________________________________________________________ Email address__________________________________________________ Corvettes Owned: Color__________________Year__________Body style ______________ Color__________________Year__________Body style ______________ Share your interests for the Club _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________