Join the good people who enjoy Corvettes!

Name:                                 

Address:                             

Phone Number:                   

Email Address:                    

Corvettes you own:             

Cell Phone Number             

Birthday    Day/Month         

Are you a member of the Corvette Museum?       

Membership dues are as follows: 

New Member - Single $55 
                            
New Member - Primary plus spouse/family $70

Please make check payable to Lanier Corvettes Unlimited and send completed form along with membership dues to:

Jim Galloway
2100 Shadwell Way
Lawrenceville, GA 30043
jimgalloway@mindspring.com


 


Pointer to a printable application.
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