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National Corvette Racing Association Membership Application |
Name: ________________________________________ |
Mailing Address: ______________________ _____________________________________ _____________________________________ _____________________________________ |
Telephone: _________________ Cell Phone__________________ |
Fax: ______________________ E-mail: ____________________ |
I accept membership and agree to the terms set forth in Membership information section of the National Corvette Racing Association. |
Signature: __________________________ Print Name: __________________________ |
Return this page only with a self addressed stamped envelope to NCRA, PO Box 504, Littlerock, CA 93543-0504 |
Corvettes Owned |
Race Car |
Year |
Model |
yes |
no |
1. 2. 3. 4. 5. |