THE OZAUKEE CORVETTE CLUB

Membership Application

.       Check type of Membership

Individual:              New $25      Renewal $20

Joint (2 Members; same address) New $30       Renewal $25

Make checks payable to the Ozaukee Corvette Club

Name:

.Birthday:

Name:

.Birthday:

.Address:

.Wedding Anniversary:

City:

State:

  Zip Code:

Phone:

E-mail:

Corvette Year:

Corvette Year:

Model:

Model:

Color:

Color:

Please Mail OCC Newsletter:

Newsletter on Website:

Please check only one box

Complete this application & bring to the next meeting or mail to:

Ozaukee Corvette Club

P.O. Box 371

Cedarburg, WI  53012

Hitting the submit button will  also send the application to  the Corvette club's Webmaster for back up.

Hitting the reset button will clear all entries and you may start over

Individual

joint

renewal

renewal

Mail

Website