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Name _________________________________________ Spouse _______________________
Address ______________________________________________________________________
City _______________________________________________ State ______ ZIP ___________
Telephone (____) ______ - __________* NCRS Membership Number (Required) _________
E-mail Address:_________________________________________________________________
* Found on Driveline or Restorer Label or you can get it from Gary
Mortimer, NCRS Membership, when you call (513) 385-8526 to join the National Corvette
Restorers Society. You must be a member of the NCRS to join the Indiana
Chapter NCRS.
| Dues: $20.00 Per Year, January to January $10.00 July 1 to January Make check or money order payable to: INDIANA CHAPTER NCRS, INC. |
Mail to: Marnie Carr 8823 E. 700 S. Elizabethtown, IN 47232 |
In order for the chapter to offer assistance to one another it is helpful if there is a
record of the models owned by our members. This is not required. Add a second sheet if
necessary.
Corvettes owned at present time: Corvettes previously owned:
Year __________ Model _________________ Year _________ Model ________________
Year __________ Model _________________ Year _________ Model ________________
Year __________ Model _________________ Year _________ Model ________________
Year __________ Model _________________ Year _________ Model
________________