Zip Code:

Home Phone:

Membership Application

Your Car Gets You Here....Our People Keep You Here!

E-mail Address 1:

Member Birthday:(Must be 21)

City:

Emergency Contact Info (other than spouse/significant other)

Member Name:

E-mail Address 2:

Address Street 2:

Address Street 1:

State:

Notice

By clicking the "Submit" button, you agree electronically to assume personal responsibility
for all risks related to participation in club automotive events and to indemnify and hold harmless
the Generations Corvette Club of the Carolinas and its officers, members, and volunteers.

Submission of your information is secured by an SSL certificate.

Please contact 65vette@bellsouth.net if you have any questions or
if you do not hear back within 2-3 days, confirming that we received your membership application.

Spouse/Other Birthday: