National Corvette Restorers Society

Central California Chapter NCRS

 

 

 

Name ________________________________________________________

 

Address_______________________________________________________

 

City ___________________________________ State _____ Zip _________

 

Phone  (Home)       _________________________

 

            (Work)        _________________________

 

            (Cell)          _________________________

 

             E-mail        ______________________________________________

 

National Membership # __________________ (being a member of NCRS National is required to join any chapter of NCRS.) Join National online at NCRS.org or call (513)-385-8526

 

Corvettes Owned _______________________________________________

 

Description (Year, Body Style, NCRS Awards earned, etc.)

______________________________________________________________

 

Are you a member of the National Corvette Museum?      Yes    No

 

You have permission to publish in the CCC/NCRS annual roster:

                My Name, Address, and Phone Number            Yes    No

                My E-mail Address                                            Yes    No

 

 

Signature______________________________________

 

Make $25 annual membership dues check payable to CCC/NCRS and mail to:

 

Bill Vyn, CCC Membership

3889 Pueblo Avenue

Santa Barbara, CA 93110

CCC/NCRS Use Only     Application received: ___________   CCC Membership # ______________ Amount enclosed__________

Membership Application