NORTH JERSEY CORVETTE CLUB
Thank you for taking an interest in the North Jersey Corvette Club
NEW MEMBER APPLICATION FORM
Dues: $75.00 Includes Two Official Club Shirts

First Name:
Last Name:
Date of Birth:
Spouse’s Name:
Date of Birth:
Address:
City:
State:
Zip:
Home #:
Work #:
Cell #:
Email:
How did you hear about NJCC:
If you own one or more Corvetters, please fill in the information below.
Vette # 1:
Year:
Color:
Engine:
Transmission:
Manual
Automatic
Body Style:
Coupe
Convertible

Vette # 2:
Year:
Color:
Engine:
Transmission:
Manual
Automatic
Body Style:
Coupe
Convertible