Leatherstocking Corvette Club
Member Information
PERSONAL INFORMATION
Name:
Last First MI
Address: City: Zip: Home Phone: Wk: Cell:
Date of Birth:
EMail Address:
Spouse Name: Date of Birth:
EMERGENCY CONTACT :
Emergency contact: Phone:
Emergency contact address:
CORVETTE INFORMATION
Year: Color:
Body Style:
Year: Color:
Body Style:
CLUB INTERESTS Cruises:
Car Shows:
Autocross:
Charity Support/Organization:
Planning - Trips/Events:
Additional Info:
Signature of Applicant: Date:
Come be a member of our Leatherstocking Corvette Club! LCC members come from the Norwich, Cooperstown and Oneonta areas. A years membership is $20.00 single and $30.00 couple/significant other. The clubs new year begins November 1st., each year. Complete this application and forward it to one of the LCC Officers (email or mail it to one of the following Members). Come enjoy your Corvette with us by participating in Cruises, Car Shows, Winery Tour and much more!
Dick Wooden, President ([email protected]) 32 Saint James Place Oneonta NY 13820 Phone 607-432-4304
Sharon Fleming, Secretary ([email protected] ) 5642 County RD 32 Norwich NY 13815 Phone 607-334-6969
Member Information
PERSONAL INFORMATION
Name:
Last First MI
Address: City: Zip: Home Phone: Wk: Cell:
Date of Birth:
EMail Address:
Spouse Name: Date of Birth:
EMERGENCY CONTACT :
Emergency contact: Phone:
Emergency contact address:
CORVETTE INFORMATION
Year: Color:
Body Style:
Year: Color:
Body Style:
CLUB INTERESTS Cruises:
Car Shows:
Autocross:
Charity Support/Organization:
Planning - Trips/Events:
Additional Info:
Signature of Applicant: Date:
Come be a member of our Leatherstocking Corvette Club! LCC members come from the Norwich, Cooperstown and Oneonta areas. A years membership is $20.00 single and $30.00 couple/significant other. The clubs new year begins November 1st., each year. Complete this application and forward it to one of the LCC Officers (email or mail it to one of the following Members). Come enjoy your Corvette with us by participating in Cruises, Car Shows, Winery Tour and much more!
Dick Wooden, President ([email protected]) 32 Saint James Place Oneonta NY 13820 Phone 607-432-4304
Sharon Fleming, Secretary ([email protected] ) 5642 County RD 32 Norwich NY 13815 Phone 607-334-6969
| leatherstocking_corvette_club_member_form.pdf |