Membership Application

For the year July 1, 2011 to June 30, 2012

New member’s dues for a full year are $25.00 + one time $5.00 initiation fee

New member’s dues for a partial year are prorated @ $2.00/month + one time $5.00 initiation fee

Please make your check payable to the “Mohawk Valley Corvette Club”

Return your check along with this form to:

The Mohawk Valley Corvette Club

P.O. Box 325

New Hartford, New York 13413

Please print & provide us with the following information for club use, only:

Name(s) {Family Members}: _________________________________________________________

Street:     _________________________________________________________________________

City:       _______________________________________Zip Code: ___________

Telephone – Home:   (        ) _______-______­­­______________

                     Cell:      (        ) _______-____________________

                     E-mail address: _____________________________________________________

Car(s):   Year________ Description________­­­­­­________________________________________

              Year________ Description________________________________________________

              Year________ Description________­­­­­­________________________________________

Note: The monthly newsletter will be sent via e-mail unless a request is made to receive it by mail.            

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Please try to attend our monthly meetings and club functions.

We welcome everyone’s input regarding club matters. 

Thank you for your support of the club.