VALPO VETTES, INC.
Membership Application
(Dues Renewal Membership: $25.00 If Paid Between Jan. 1st And Feb. Meeting.)
($30.00 If Paid After February Meeting.)
(Dues New Membership: $30.00)
Name: Spouse:
T-Shirt Size: T-Shirt Size:
Address:
City: State: Zip:
Home Phone: Cell Phone:
2nd Cell Phone: Name:
Provide cell numbers for communicating on cruises. Phone list to be issued for glove box.
Email: (Please print legibly)
Birthdays: (Month/Day only) You: Spouse:
Anniversary:
Year of Corvette #1 Color Convertible T-Top
Year of Corvette #2 Color Convertible T-Top
Year of Corvette #3 Color Convertible T-Top
I have Club Flag: Yes: No:
I have Club name tag: Yes: No:
Signature: Date:
Valpo Vettes, Inc.--P.O. Box 1281--Valparaiso, In. 46384