CONNECTICUT CLASSIC CHEVY
CONNECTICUT CLASSIC CHEVY
Dedicated to the preservation and restoration of Classic Chevrolets. The club is opened to people having an interest in all Chevrolet model vehicles manufactured up till 1972.
Excluding vans, trucks or commercial vehicles over 3/4 ton.
PLEASE PRINT
Name: ____________________________New Member: ______ Renewing Member:_______
Spouse / Other: ______________________________________
Address: _________________________________________Tel # ____________________
City: ______________________ State: ______Zip: ________ CCI Member # ___________
E – Mail Address: __________________________________@______________________
Signature: __________________________________________ Date: ________________
Each member will receive one (1) Membership Card, the Club’s Newsletter "CLASSIC LINES", one (1) decal, and Club Membership for the current calendar year. You will be allowed to participate in all club functions and activities. Members will be entitled to free advertising in the Club ‘s Newsletter. However, a fee of $5.00 will be charged if a colored photo is included in the advertisement.
New Membership Dues $ 25.00 ● Renewal Membership Dues $ 25.00
(Due and Payable by January 31)Return Application & Membership Info Form, a check or money order payable to: CT. CLASSIC CHEVY
Send to: June Mamula ● 265 Frost Street ● Plantsville, CT. 06479Please note: The Ownership of a Chevrolet is
not prerequisite for membership.Please list all Chevrolets 1972 and older that are owned by you.
YEAR ● MODEL ● BODY STYLE ● COLOR ● REMARKS
________ /___________ /_________________ /____________ /________________________
________/____________/_________________/_____________/________________________
MEMBER INFORMATION FORM
Please Complete Form and Return with Membership Application
PLEASE PRINT
Husband - Wife - etc.
Name: (1)___________________________________________________________________
Name:(2)______________________________________________________
Birth Dates: (Year not necessary) 1) ____________________2)_______________________
Wedding Anniversary Date: (
Please give full date) ___________________________________Children: Name ● Date of Birth Name ● Date of Birth
_______________ ____________ ______________ __________
_______________ ____________ ______________ __________
_______________ ____________ ______________ __________
Hobbies: _______________________________________________________________
_______________________________________________________________
Special Skills: ___________________________________________________________
___________________________________________________________
Other information: ________________________________________________________
___________________________________________________________
E-Mail Address: __________________________________@_____________________
TO PRINT THIS FORM PLACE YOU CURSOR ON THIS PAGE AND RIGHT CLICK IT THEN SELECT PRINT
CLUB JACKET ORDER FORM
A $35.00 Deposit for each jacket must be included. Make checks payable to: CT. Classic Chevy
The balance of $40.00 is due upon receipt of the jacket. The total cost of a jacket is $75.00
Member Name: ____________________________ Date: __________ Deposit: $ _________
Name on Jacket: Size: (S, M, L, XL, XXL) Style: (Snap Only)
1. _________________________________________________________________________
2. _________________________________________________________________________
3. _________________________________________________________________________
4. _________________________________________________________________________
NOTE: As voted on at the August ’95 meeting
ONLY immediate family members can order jackets. If you have any questions, please call one of the board members.
TO PRINT THIS FORM PLACE YOU CURSOR ON THIS PAGE AND RIGHT CLICK IT THEN SELECT PRINT