Diamond State Corvette Club - Membership Application
Subject:
Name:
Email:
Address:
City:
State:
Zip
Home Phone:
Work Phone
Fax Number
Cell Number:
Birthdate (MM/DD)
Signicant Other or Spouse Name:
Signicant Other or Spouse Cell Phone:
Signicant Other Birthdate (MM/DD):
Style of Corvette (Coupe, Conv., Z06, etc.):
Year of Corvette:
Color of Corvette:
Questions/Comments
Club Dues are $25 annually.
You will be contacted prior to our next meeting.  Welcome!!!
Membership Application