Membership Application
About You              * indicates required field
Member Applicant *
2nd Applicant (if any)
spouse/partner/relative
Address
Postcode
Home Phone
Mobile Phone
Work Phone
Email *
Occupation
Interests / hobbies
Birthday
2nd applicant Birthday
Activities of Interest
(check all that apply)
Car Shows Social Gatherings Track Days
Meetings  Cruise Nights Weekend Getaways
Do you currently
own a Corvette?		 Yes No
Are you looking for one? Yes No
About Your Corvette
Year
Body Style Coupe Convertible Hard-Top
Exterior Colour
Interior Colour
Engine
Transmission
Owner Since

Additional Information

eg. options modifications / vehicle history / story)

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