Corvettes of Berkshire

Membership Application Form

Name: Date of Birth:
Spouse/Significant Other: Date of Birth:
Address:
City: State: Zip Code:
Telephone Number:

"Birthdates + Anniversary Dates for use in Club Announcement Calender"

Anniversary-Date:
2nd Additional Date:
3rd Additional Date:

"Children's Names & Birthdays"

Child 1: Date of Birth:
Child 2: Date of Birth:
Child 3: Date of Birth:
Child 4: Date of Birth:

"Vette Information"

Year of Vette:
Color:
Model:
"Additional Vettes"

Year of Vette2:
Color:
Model:

"What type of events do you enjoy?"

All Information is kept Confidential
homeCorvettes of Berkshire Home-Page.