Central Valley Corvettes - October 2014 Magazine
Central Valley Corvettes of Fresno, October 2014
Central Valley Corvettes of Fresno, October 2014
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CENTRAL VALLEY CORVETTES<br />
MEMBERSHIP APPLICATION<br />
NEW ________ RENEWAL ________ (Check one)<br />
NO CHANGE _____(Check if all Information is the same since your last renewal, sign & return along with dues & copy of current insurance)<br />
MEMBER 1 __________________________________________________________DATE OF BIRTH _____________<br />
LAST FIRST BADGE NAME (If different)<br />
MEMBER 2 __________________________________________________________DATE OF BIRTH _____________<br />
LAST FIRST BADGE NAME (If different)<br />
ADDRESS _________________________________ CITY ___________________ STATE ________ ZIP __________<br />
DATE OF WEDDING ANNIVERSARY _______________<br />
MM/DD/YY<br />
PHONE 1 _______________ _______________ ______________ _______________ ___________________________<br />
HOME WORK CELL FAX E-MAIL<br />
PHONE 2 _______________ _______________ ______________ _______________ ___________________________<br />
HOME WORK CELL FAX E-MAIL<br />
MEMBER 1 _______________________________ _____________________________ ______________________<br />
EMPLOYER OCCUPATION DRIVERS LICENSE NUMBER<br />
MEMBER 2 _______________________________ _____________________________ ______________________<br />
EMPLOYER OCCUPATION DRIVERS LICENSE NUMBER<br />
CORVETTES<br />
YEAR _________ MODEL __________________ COLOR ________________ LICENSE _____________<br />
YEAR _________ MODEL __________________ COLOR ________________ LICENSE _____________<br />
YEAR _________ MODEL __________________ COLOR ________________ LICENSE _____________<br />
THE UNDERSIGNED DESIRES TO ENTER AND PARTICIPATE IN CENTRAL VALLEY CORVETTES. IN CONSIDERATION OF THE<br />
ACCEPTANCE OF THIS MEMBERSHIP APPLICATION THE UNDERSIGNED DOES HEREBY RELEASE CENTRAL VALLEY CORVETTES, IT'S<br />
DIRECTORS AND ALL OTHER PERSONS AND ENTITIES INVOLVED WITH THE ORGANIZATION FROM ANY AND ALL LIABILITY FOR<br />
INJURIES OR DAMAGES WHATSOEVER TO PERSON OR PROPERTY THAT MIGHT OCCUR WHILE PARTICIPATION IN THIS ORGANIZATION.<br />
THE UNDERSIGNED AGREES TO ABIDE BY THE CURRENT BY-LAWS OF CENTRAL VALLEY CORVETTES.<br />
MEMBER 1 ______________________________ ________ MEMBER 2 _______________________________ ________<br />
SIGNATURE DATE SIGNATURE DATE<br />
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Remember to turn in the following: CLICK ON THIS PAGE TO GET A COPY TO PRINT<br />
1. Membership Form<br />
2. Dues - (Check made to “CVC”)<br />
3. Copy of Current Insurance Information<br />
The above is required for membership and membership renewal and must be received by the Dec. meeting but no later than Dec. 31<br />
Please give to membership chairperson or mail to:<br />
CVC<br />
P.O. Box 26591<br />
Fresno, CA. 93729-6591<br />
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INTERNAL USE ONLY<br />
AMOUNT RECEIVED $ _________________ DATE RECEIVED _______________ CHECK # ___________<br />
COPIES TO: MEMBERSHIP, SECRETARY & TREASURER