ETCC - Membership Application

Please note that your dues include membership in the National Council of Corvette Clubs, Inc. (NCCC). This is a mandatory requirement for liability insurance purposes. For more information about NCCC, click here.
Type of Membership*

Single PersonCouple
Membership Type

Member Information
Primary Member's Gender*

MaleFemale
Primary Member's Name*
Primary Member's Phone Number*
Please enter a valid phone number.
Primary Member's Email*
Confirm Email
Email address does not match, please correct.
Email Address Matches
By clicking the below box, you consent to receive email communications from the East Tennessee Corvette Club.
Email Consent

Email Consent
Spouse / Significant Other - Gender*

MaleFemale
Spouse / Significant Other - Name
Spouse / Significant Other - Email
example@example.com
Spouse / Significant Other - Phone Number
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState

Zip Code

As required by NCCC, your signature certifies that you are at least 16 years of age.
Primary Member's Signature*

Clear
Spouse / Significant Other Signature*

Clear

Payment
The default payment method is debit / credit card. Cash or checks can only be selected if payment is made at a monthly club meeting. An authorization code is required for a cash / check payment. You can obtain the authorization code from the club treasurer or from a membership coordinator. A small handling fee is added for all credit / debit card transactions.

If you hold a current NCCC membership with another Corvette club, the NCCC portion of the dues are waived, please notify the membership team.
Membership Team Authorization Required?

NoYes
Authorization Code
Provided by ETCC authorized personnel
Membership Dues
Handling Fee
Total Annual Dues
Total Membership Dues
Payment Type*

Check / CashDebit / Credit Card
NCCC Membership*

Never or Past MemberCurrent NCCC Member with Another Corvette Club
Name of Current NCCC Affiliated Corvette Club Membership*
Make checks payable to ETCC

Mail Payments to:

ETCC

12617 Wagon Wheel Circle

Farragut, TN 37934
Renewal Date

MonthDayYear
Date
Method of Payment
Membership Paid Thru
Status
Membership Approved

Yes
Treasurer Approved

Yes
ETCC Annual Dues via CC*

prevnext( X )
USDDescription
Date Paid

MonthDayYear
Date
Check #

East Tennessee Corvette Club