LAKE TAHOE CORVETTE CLUB

P.O. Box 6807, Stateline, NV  89449

 New Member Information/Renewal Form

 Date:   ____________                         NewMember$20.00___  Renewal___  Check one

 Name: ______________________________________________ Birthday (mm/dd)______

 Spouse/Sig.Other  ____________________________________  Birthday (mm/dd)______

 Mailing Address:_____________________________________ Anniversary _______

 City:  ________________________   State ______  Zip __________

 Home Phone   (      ) ____________

 Cell Phone #1 (      ) ____________   Cell Phone #2   (      ) ________________ (Cell numbers are optional)

Email address: __________________________________________________

 Corvette Info

 Year                Color                                                   Special Information

 ____               _______________              __________________________

                                                                        __________________________

____               _______________              __________________________

                                                                        __________________________

____               _______________              __________________________

         Please return completed forms and your check to Club address at top of sheet

Club dues are $20.00 and include member and spouse/SO.
***New members must join WSCC and pay first year dues. Club will pay
WSCC dues thereafter on a yearly basis as long as Club dues are paid by Dec.15th.
WSCC dues are prorated according to the time of year membership begins.
Please see chart on application.