Membership Form

Join Us at our next meeting!
Having fun and enjoyment is a key to being a successful member to our club.
If this sounds like something you are interested in please fill out the form below with a check for your dues and mail to:

Mid-Missouri Corvette Club
P.O. Box 7256
Columbia Mo.65205

If you would like to check us out first please contact any member or join us at our next meeting.

Membership Dues: Club dues are$24.00 per year and are pro-rated at 2.00 per month for the reminder of the fiscal year joined. The fiscal year runs from July 1st through June 30th. Skipping the current month and then counting the months between then and June and multiplying by $2.00 can calculate the amount of dues owed.
Name:______________________________________________________

Name:______________________________________________________

Address:____________________________________________________

Address:____________________________________________________

Home Phone:_________________________________________________

Mobile/Cell Phone: ____________________________________________

Email:_______________________________________________________

Car(s): Year, Model, Color etc.___________________________________
___________________________________________________________

Birthdays: indicate month and day _________________________________
___________________________________________________________

Personalized Plates:____________________________________________

Privacy Statement: The above information is to be used for MMCC business and maintained in a Club Directory that is distributed to members only. Any dissemination, distribution or copying of this information without permission is strictly prohibited.

Right-Click inside this frame and choose PRINT to print the form.