GRCC Membership Application

MEMBERSHIP APPLICATION

Glass Reunion Corvette Club

P.O. Box 32067

Billings, MT. 59107

Name(s):___________________________________________________________

___________________________________________________________________

Address:____________________________________________________________

City:__________________________________ State:___________ Zip:_________

E-mail:_____________________________________________________________

Cell Phone: ________________________ Cell Phone: _______________________

Home Phone: ______________________ Work Phone; _____________________

Year of Car: ________ Body Style: _________ Model: _________ Color: ________

Signature(s): ________________________________________________________

___________________________________________________________________

Yearly Dues: Single - $20.00 Couples – $40.00

Please pay by check only.

Please mail completed and signed application with payment to the address at the top of this form.

Please email a photo of your Corvette(s) to the Web Master for posting to this site.