NAACC Houston Application Form

MEMBER APPLICATION FORM

I hereby apply for membership in the Houston Chapter of the National Afro-American Corvette Club for Corvette Owners. I will obey the code of conduct, rules and regulations set forth by the Board od Directors as allowed by the Club By-Laws.

Name*

First NameLast Name

Email address*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

Would you like to receive messages and club updates via text message to the phone number listed above? By selecting YES you are authorizing NCCAA Houston to communicate through TEXT messages. Additional data usage charges may apply. Please check with your wireless provider for more details.*

YesNo

Spouse's Name

How did you hear about NAACC?

Current or pass member of another Corvette club?

YesNo

If Yes, Name blanks and Year blank.

Comments

The information contained within is confidential, will be maintained by the Membership Chair, and authorized Officers at the club's discretion. This information will NOT be sold or shared with any outside entities

Signature*

Date*

Date