APPLICATION
Steve Hart, President
445 Elm Street
Lincolnton, N.C. 28092
Phone 704-349-1053      





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Carolina Classic Chevy Club

Membership Application

1955 1956 1957 CHEVY’S

Date:                  ___________________                        Paid By:        Cash_____
                                                                                    Check____

Name:                __________________________________________________________________________

Spouse’s name:        __________________________________________________________________________

Address:                __________________________________________________________________________

__________________________________________________________________________

Phone #:                __________________________________________________________________________

Fax #:                __________________________________________________________________________

Email Address:        __________________________________________________________________________

Car Information

Year:                ___________________________________________________________________________

Make:                ___________________________________________________________________________

Model:                ___________________________________________________________________________

Color:                ___________________________________________________________________________


Other Information about Car



Optional Information:

Anniversary:                        _______________________________

Birthday:                        _______________________________

Spouse’s Birthday                _______________________________


                                 Club Meetings 2nd Tuesday of each Month
                Dues $24.00 per year – due on or before March 1st of each year.  
Printable Application
Roger Austin, Vice - President
1538 Union Grove Road
Lenoir, N.C. 28465-7365
Phone 828-728-7377
Sheila Fraley, Treasurer
3529 Stokes Road
Denton, N.C. 27239
Phone 336-859-2350
Cell 704-425-9507