ON-LINE APPLICATION

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Name *
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Address *
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Phone No. *
Cell #
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Occupation or Business
Name Of Spouse
Birth Month & Day
	New Member
	Membership Renewal
	Family Membership $35 - 2 Person Membership
	Regular Membership $25
	Social Membership $25 - Past Member No Longer Owning a Corvette
No. Of Corvettes *
Year
Body Type
Engine CI
Transmission Type
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Interior Color
Special Features
Year
Body Type
Engine CI
Transmission Type
Exterior Color
Interior Color
Special Features
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Thanks for your interest in the Altoona Corvette Club.

Please send a picture of your car(s) for our records. It is better if the picture includes the owner(s). These pictures may be used in future club publications and the Internet membership directory.

Make payment for membership payable to: The Altoona Corvette Club

Please forward membership payment and pictures of your car(s) to:

The Altoona Corvette Club

P.O. Box 2346

Altoona, PA 16603