APPLICATION
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Steve Hart, President
445 Elm Street
Lincolnton, N.C. 28092
704-349-1053
.
Carolina Classic Chevy Club
Membership Application
1955 1956 1957 CHEVY’S
Date: ___________________ Paid By: Cash_____
Check____
Name: __________________________________________________________________________
Spouse’s name: __________________________________________________________________________
Address: __________________________________________________________________________
__________________________________________________________________________
Phone #: __________________________________________________________________________
Fax #: __________________________________________________________________________
Email Address: __________________________________________________________________________
Car Information
Year: ___________________________________________________________________________
Make: ___________________________________________________________________________
Model: ___________________________________________________________________________
Color: ___________________________________________________________________________
Other Information about Car
Optional Information:
Anniversary: _______________________________
Birthday: _______________________________
Spouse’s Birthday _______________________________
Club Meetings 2nd Tuesday of each Month
Dues $24.00 per year – due on or before March 1st of each year.
445 Elm Street
Lincolnton, N.C. 28092
704-349-1053
.
Carolina Classic Chevy Club
Membership Application
1955 1956 1957 CHEVY’S
Date: ___________________ Paid By: Cash_____
Check____
Name: __________________________________________________________________________
Spouse’s name: __________________________________________________________________________
Address: __________________________________________________________________________
__________________________________________________________________________
Phone #: __________________________________________________________________________
Fax #: __________________________________________________________________________
Email Address: __________________________________________________________________________
Car Information
Year: ___________________________________________________________________________
Make: ___________________________________________________________________________
Model: ___________________________________________________________________________
Color: ___________________________________________________________________________
Other Information about Car
Optional Information:
Anniversary: _______________________________
Birthday: _______________________________
Spouse’s Birthday _______________________________
Club Meetings 2nd Tuesday of each Month
Dues $24.00 per year – due on or before March 1st of each year.
Benny White, Vice - President
104 Turtledove Lane
Statesville, N.C. 28677
Phone 704-872-4594
104 Turtledove Lane
Statesville, N.C. 28677
Phone 704-872-4594
Sheila Fraley, Treasurer
3529 Stokes Road
Denton, N.C. 27239
Phone 336-859-2350
Cell 704-425-9507
3529 Stokes Road
Denton, N.C. 27239
Phone 336-859-2350
Cell 704-425-9507