Membership Application (DOC download)

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					                         Mid America Chevelle Club
                           Website: midamericachevelles.com
                                  Invites You to Become a Member

       Kansas City Area Active local Chapter for Chevelle, El Camino, & Sprint Enthusiasts!
       Membership $ 25 a year per family.
       Monthly meetings @ Superior Chevrolet, Merriam Ks.7:00 pm.
       Monthly newsletter, details club activities, and upcoming events.
       Family fun, Cruises, Car Shows and more!
       American Chevelle Enthusiasts Society “ACES” affiliated.

  TO JOIN, complete form and mail $ 25.00 to: Mid America Chevelle Club
                                              c/o Eugene Hallouer
                                              12318 W 61st.
                                              Shawnee Kansas 66216
  Questions? Please contact us:
  President: Roger Verstraete (913) 207 3374; Vice President: Ed Smoot (913) 636 2002;
  Treasure: Eugene Hallouer (913) 248 0288

New_________________or Renewal____________Member#______________________Date___________________-

Name: ________________________________________ Spouse:___________________________________

Address: ___________________________________City____________________State_________________

Phone Number: _______________________Cell Phone___________________________________________

 Email___________________________________________________________________________________
Your Chevelle(s) include Model, Color, How long you owed car, etc.:
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________

Your Interests (Choose as many as you like):

 ___ Cruising ___Car Shows ___ Tech Info        ___ Tours ___ Parties ___ Other (explain)
_______________________________________________________________________________________
How did you find out about Mid America Chevelle Club?

____ Internet   ___Car Show Flier ___ Club member ___ Web site ___ Business Card
_____ Newsletter _____Friend ______Chevelle Word Magazine ____Radio TV____Other (explain)

Comments:
_________________________________________________________________________________________
_________________________________________________________________________________________

Signature_________________________

				
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posted:11/19/2011
language:English
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