Name: CANCELED ‐ CCKC Picnic
Start: 2020-07-26T15:00:00-05:00
End: 2020-07-26T21:00:00-05:00
Location: None

This application will be submitted to the Club Membership Chairperson.

The annual Membership cost for the club is $45 for a primary member and an additional $10 for spouse/significant other(if they choose to join).

You can use PayPal to submit payment at CorvetteClubofKC@gmail.com after submitting this application.

Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Email Address*
Date of Birth*
Cell Phone*
Home Phone
Work Phone
Occupation
Employer
Spouse/Significant Other
Name
Date of Birth
Email Address
Anniversary Date
Cell Phone
Home Phone
Work Phone
Employer
Occupation
Corvettes
Year*
Model*
Color*
Year
Model
Color
How Did You Hear About Us?
Please Enter The Text Below

Corvette Club of Kansas City

Club Membership Application

Spouse/Significant Other

Corvettes

Sponsored by Hendrick Chevrolet Shawnee Mission