Mohawk Valley
Corvette Club, Inc.
Membership Application

Please print this form by clicking on the form then clicking Print in your browser.
Fill it out clearly, and send it along with your check or money order for $25 to:

The Mohawk Valley Corvette Club
P.O. Box 325
New Hartford, New York 13413


Name:________________________________________________________________________________

Spouse or Significant other:______________________________________________________________

Address:______________________________________________________________________________

Home Phone:__________________________________Cellular:_________________________________

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Email:________________________________________________________________________________

Would you prefer to receive your newsletter by email only:   Yes______  No______

Sponsored by:__________________________________________________________________________

Corvette Year:__________________Color:__________________________Model:__________________

Corvette Year:__________________Color:__________________________Model:__________________

Corvette Year:__________________Color:__________________________Model:__________________