Membership Application

CRCC membership is $25.00 per year. January though December 31st. Club meetings are held
monthly or at discretion of the members. The location of the meeting will be announced at the
meeting or by e-mail or phone.

CRCC is affiliated with National Council of Corvette Club (NCCC)

*Dues for the NCCC, 1st Year $35.00 $10.00 for Spouse ($45.00)
2nd Year $25.00 $10.00 for spouse ($35.00)
Membership Information

Date: _____________ Birthday: (Month/Day) _____________________

Spouses Birthday: (Month/Day) ________________
Anniversary: ___________________

Name(s) ____________________________ Spouse/Other_____________________________

Address: ______________________________________________________________

City ________________________ State: ______ Zip: ______________________

Phone: ______________________ Cell Phones: ____________________________

Email(s): _________________________/__________________________________

Type of Corvette(s) Year_________ Model _______________ Color: ____________

__________ ________________ _____________
Other Information: _____________________________________________
By checking this box you agree that all drivers have a valid Driver's License and that
you currently have and will maintain current registration & Liability Insurance on your
Corvette(s) during your membership with Colorado River Corvette Club

Send completed application to: * To be a member of CRCC you must

Colorado River Corvette Club complete the application to the
C/O: Steve Barajas National Council of Corvette Clubs.
2276 E. Osprey Cove
Ft. Mohave AZ. 86426 Check # _________ Amount: _________
Cell # 928-278-7528 Total $70.00 Per Couple - $60.00 Per Single
Make one Check for both Clubs Payable to: Colorado River Corvette Club