Membership Application :

C O R V E T T E S   O F   P A,  I N C.

MEMBERSHIP APPLICATION

P.O. BOX 224

BEAVAER, PA 15009-0224

We are now accepting Applications for Membership in Corvettes of PA, Inc.


For information about club events, meeting times and locations, contact any of the Officers listed on 

the "Officers" page or visit our website

www.corvetesofpa.com

New Member dues is $35 per year for the Corvette Owner and spouse/companion, payable upon 

acceptance by the organization. Membership renewal is $30.00 per year when paid between 

Sept 1 and  Dec 31 of the current year. After Dec. 31 renewal will be $35.00.

By submitting this Application, the applicant confirms that he/she is a Corvette owner, is 21 years of age, 

and has a valid current driver's license.

To apply for membership, print this Application, fill in all information, attach your check, and mail

 the lower portion of this Application to;

Corvettes  of  PA,  Inc.

P.O.  Box  224

Beaver,  PA  15009 - 0224


Make all checks payable to Corvettes of PA, Inc.

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

NAME: ________________________________________________

BIRTHDATE: ___________________________________________

SPOUSE?S NAME:________________________________________

BIRTHDATE: ___________________________________________

ANNIVERSARY: _________________________________________

ADDRESS: _____________________________________________

HOME PHONE:  (       ) _______________________________

CELL PHONE:  (       )________________________________

EMAIL ADDRESS: _______________________________________

YEAR OF CORVETTE (S): ________________________________

BODY STYLE & COLOR: __________________________________

SPECIAL OPTIONS:  ____________________________________