Membership Application

 

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FALLS CITY CORVETTE CLUB EST. 1964

LOUISVILLE, KY

MEMBERSHIP APPLICATION

 

Name  Birthday   

Spouse's Name Birthday  

Address  

Wedding Annv.  

 Phone #  Cell Land Line (Please Let us know if Cell or Land line.)

 Work #   2nd Phone  Cell Land Line (Please Let us know if Cell or Land line.)

Email  

Year   Style Color  

 

Did you purchase your New or Used Corvette from Bachman Auto Group within the last 6 months?  Yes  No    --------------  If Yes --->

When - Your purchase entitles you to (1) free one year membership to Falls City Corvette Club.

 

Fees for New Members are  $30.00 Per Person. Members Dues Yearly afterwards is $30.00 Per Person Per Year.

Membership Type ( X )       Single    Couple

 If dues are paid after September 30, you will be considered a Club Member for October thru December and your dues will apply to the following year's Membership.

PLEASE READ AND CHECK: FCCC dues shall be $30.00 annually per person.  Dues are to be paid by January 31st of each year.  Must be at least 18 years of age.

I HAVE READ AND AGREE TO THESE TERMS               YES

SUBMITTED BY  DATE

 

MAKE CHECKS PAYABLE TO FALLS CITY CORVETTE CLUB

 

 

 MAIL TO:

                    FALLS CITY CORVETTE CLUB
                    C/O  TROY BENNETT
                    P.O. BOX 21727
                    LOUISVILLE, KY 40221-0727
 
 PAYMENT IS TO BE RECEIVED  WITHIN  7 DAYS OF SUBMITTED APPLICATION
Please print a copy of this form and mail with Payment.

 

Items in Red are a must

 

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