Print this form and mail to the following:
Northern New York Corvette Club
1152 Harrison Street
Watertown, New York 13601
$20.00 annual fee
Membership Application
Name:__________________________________________________________________
Significant Other:___________________ Relationship:_________________________
City:___________________________________________________________________
Address:________________________________________________________________
State/Province:_____________________ Postal Code:__________________________
Home Phone:_______________________ Work Phone:________________________
Year of Car:_______________________ Coupe/Convertible/Hardtop:____________
Color:_____________________________ Special Feature:_______________________
E-Mail Address:_________________________________________________________