New Membership Signup | StateLine Corvette

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New Membership Form

Select your membeship type *

*NEW* Membership - SINGLE - includes (1) membership and (1) nametag - $33.00

*NEW* Membership - COUPLE - includes (2) memberships and (2) nametags - $66.00

Enter your information

(*) indicates a required field

Applicant First Name

Applicant Last name

Applicant Email

Co-applicant First Name

Co-applicant Last name

Co-applicant Email

Street Address

City

State

Zip Code

Applicant Cell Phone (xxx-xxx-xxxx)

Co-applicant Cell Phone (xxx-xxx-xxxx)

Share some fun things

Hobbies and Interests

Where applicant grew up

Where co-applicant grew up

Applicant Birthday (month/day)

Co-applicant Birthday (month/day)

Applicant Anniversary (month/day)

Describe your Corvette(s)

Model Year

Model

Body Style

Color

Click to add 2nd Vette

Year 2nd Vette

Model 2nd Vette

Body Style 2nd Vette

Color 2nd Vette

Click to add 3rd Vette

Year 3rd Vette

Model 3rd Vette

Body Style 3rd Vette

Color 3rd Vette

Click to add 4th Vette

Year 4th Vette

Model 4th Vette

Body Style 4th Vette

Color4th Vette

Most members use first and last names for name tags...

Nametag for Applicant

Nametag for Co-applicant

How did you hear about StateLine Corvette Club Corvette Club? *

A StateLine Member

Car Show

Drive and Dine

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Internet

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