4-State Vettes
Application

Thank you for your interest in becoming a member of 4 State Vettes! We look forward to having you participate in our monthly meetings and events. We meet the 2nd Tuesday of each month at 7:00 p.m. at Granny Shaffer's Restaurant at 2728 North Rangeline, in Joplin, Missouri. Our club dues are $30.00 per year for couple, or $20.00 per year for single.  Checks can be made payable to:

4 State Vettes

Please send your completed application and dues to the address below. See you soon!

Please Print

Name: _______________________________________________

Significant Other: _____________________________________

Street Address: _______________________________________

City: ________________________State: _______Zip: _______

Home Phone: (____)__________________________________

Work Phone : (____)__________________________________

Cell Phone: (____)__________________________________

E-Mail: _____________________________________________


Year/Model of Corvette(s) owned: _______________________

(i.e. 1963 Coupe)

Send To:
4 State Vettes
P.O. Box 2074
Joplin, Mo. 64803-2074
(417) 776-8858

Welcome!         Tell your Corvette friends!

 

Date of Application: _______________________