Membership/Registration Form (Indy 500 Pace Cars)

Membership/Registration Form
(For : 1978, 1986 Convertibles, 1995, 1998, 2003 Anniversary Editions with 2002 Race Graphics, 2007, or 2008 Indianapolis 500 Pace Cars only)
Complete this Online Form to Register your Pace Car, and you can also Submit your First Year Dues via Paypal using your PayPal account or your Credit Card to become a Member of the Chevrolet Corvette Pace Car Registry !

Membership runs from January 1 to December 31, You will receive an annual renewal email and the renewal payment is due by January 15th. Please note joining initially in October, November or December will also cover your membership for the following year.

(If you have more than one Corvette Pace Car you wish to Register, please use this form again for each car (Note, additional Pace Car Registrations are no Additional Charge once you pay your initial dues !)
Please complete all fields below to register your car.
Owner Information
How an we help you today?*
Year Registering*
Last 5 digits of your VIN*
Owner(s) Name (Membership is by Vehicle) *

First NameLast Name
Preferred E-mail Address*
Mailing Address*

Street Address

Street Address Line 2

CityState/Province

Postal/Zip CodeCountry
Preferred Phone Number (For U.S. use 1 as Country Code)*

Country CodeArea CodePhone Number
Vehicle Information
Purchase Date *
If your Corvette was a Track Event, or Festival Car used at the Indianapolis 500 and you know it's assigned number, Please enter the number here :
Transmission*
(1986 Only) Exterior Color
(1986 Only) Interior Color
(1986 Only) Convertible Top Color
(2003 or 2008 Only) Body Style
(2007 or 2008 Only) Corvette Museum Delivery?
Mileage*
Does your car have the Event Graphics applied?*
Other Comments/ Information about your car:
If you want to also become a Full Member of the Registry at this time, By clicking on the button below you will be taken to PayPal, where you can submit your payment from your PayPal account or Credit Card. If not, you can skip this step and proceed to Submit your registration.
JOIN US NOW --------> PLEASE CLICK ON THE BUTTON TO THE RIGHT TO BE DIRECTED TO PAYPAL TO MAKE YOUR DUES PAYMENT !!
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Pace Car Registry Membership Dues (1 year)$25.00

Total $0.00
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(For : 1978, 1986 Convertibles, 1995, 1998, 2003 Anniversary Editions with 2002 Race Graphics, 2007, or 2008 Indianapolis 500 Pace Cars only)