CENTRAL TEXAS CLASSIC CHEVY CLUB

[Pages:1]Central Texas Classic Chevy Club Membership Form

MEMBER NAME MEMBER EMAIL MEMBER CELL # BIRTHDAY

(Year Not Required)

WEDDING ANNIVERSARY NATIONAL CLUBS

CCI # BOWTIE #

VCCC # OTHER CAR CLUB AFFILIATIONS

SPOUSE NAME SPOUSE EMAIL SPOUSE CELL # SPOUSE

(Year Not Required)

ADDRESS CITY, STATE ZIP

CLASSIC CHEVYS YOU OWN (please include brief description ex: 1956 BelAir H.T., red & white original)

OTHER CLASSIC CARS YOU OWN

Membership dues are $25.00 to be paid annually. Make check payable to CTCCC.

Please mail your check with this membership form to: CTCCC, c/o Kay Bowen, 10503 Oak Valley Trail, Austin, Texas 78736

Thank you and please keep the officers informed of any changes or errors.

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