Northwest Classic Chevy Club - Membership Application

Northwest Classic Chevy Club
Membership Application

Tell us about yourself!
Full Name
Address
City	State	Zip
Phone	Email
What classic Chevy do you drive (or are working on)?
Year	Model	Color
What work have you done to your car?

Any special skills or interests?

What would you like to get out of your membership with NWCCC?

Club dues are $25.00 per year (Jan 1 - Dec 31) / Prorated (July to Dec) $12.50

Return this completed form along with your payment to:

NWCCC Membership
5440 36th Ave SW
Seattle, WA 98126

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Signature	Date