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GREATER NEW ORLEANS CORVETTE CLUB

MEMBERSHIP APPLICATION

(Please Print or Type)

NEW MEMBER__________       RENEWAL__________

LAST NAME __________________________________________________FIRST NAME ________________________________ MI _____

ADDRESS ____________________________________________________________________________ 
    

CITY _____________________________________________________STATE _______ ZIP Code ___________________

BIRTHDATE ______________________EMPLOYER _____________________________________________________________

HOME PHONE ______________________CELL PHONE _________________ WORK PHONE _________________

EMAIL ADDRESS ___________________________________________________________________________________________________

                                                                                            Spouse/Associate

NAME ____________________________________________________________BIRTHDATE _________________________

CELL PHONE ____________________________________________________ 

   

EMAIL ADDRESS __________________________________________________________________________________________________________


                                                                                Corvette Information

YEAR ______________ BODY STYLE ___________________________________ ___ COLOR ______________________________________________________

YEAR ______________ BODY STYLE ____________________________________ ___COLOR _____________________________________________________

YEAR ______________ BODY STYLE ________________________________________Color_______________________________________________________

 

PLEASE CHECK APPROPRIATE MEMBERSHIP

_____ $100.00 REGULAR MEMBERSHIP (INCLUDES 2 ADULTS)

 _____ LIFETIME MEMBER (NO PAYMENT DUE)

 _____ $50.00 SPOUSE/PARTNER OF LIFETIME MEMBER

                                                        

                                                                                   CHECKS SHOULD BE MADE PAYABLE TO GNOCC AND MAILED TO:

                                                                               Greater New Orleans Corvette Club, PO Box 113244, Metairie, LA 70011


 GREATER NEW ORLEANS CORVETTE CLUB, PO BOX 1 , LA 70011

                                                                                                                        FOR CLUB USE ONLY

DATE RECEIVED __________________________________ AMOUNT_______________________ CHECK NUMBER____________________ 

 GREATER NEW ORLEANS CORVETTE CLUB, PO BO A 70011



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General Membership Meeting

Friday
July 6, 2018

Elks Lodge
 2215 Cleary Ave
Metairie, LA


Elks will have food
starting at 6PM

Meeting starts at 7:00 PM





Click Image for Calendar


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