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Membership Application
(Please Print)
NAME________________________________________________________ AGE ______________
ADDRESS ________________________________________________________________________
CITY _____________________________________ STATE ____________ ZIP ________________
DATE OF BIRTH ____________________________ MARRIED -- YES_____ NO _____
HOME PHONE ( ) _______________________ BUSINESS PHONE ( ) _______________
OCCUPATION _____________________________________________________________________
SPOUSE’S NAME ______________________________________________ AGE________________
DATE OF BIRTH _____________________________ OCCUPATION ________________________
CORVETTE YEAR ____________________________ MODEL ______________________________
LICENSE PLATE NUMBER ____________________ STATE _______________________________
HOBBIES OR SPECIAL INTERESTS ___________________________________________________
___________________________________________________________________________________
SIGNATURE _________________________________________________ DATE ________________
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Our membership fee is $20.00 per year, due in January of each year. Make checks payable
to "SEACOAST VETTES". Owning a corvette is the only prerequisite to joining our
club. Jackets (winter or spring) are available at club prices. Jackets are not mandatory