Membership Application - New and Renewal

DACC Dues are $20.00 per year

Print this form, Fill it in, and mail it with your check or money order, payable to Detroit Area Corvair Club to:

John Allesee - DACC
P. O. Box 549
Saline, MI  48176-0549
E-Mail

Name ________________________________        Home Phone ________________________

Address ______________________________        Cell Phone _________________________

City, State, Zip _________________________________________________________________

Email address __________________________________________________________________

Other club affliations ___________________________________________________________

Your Corvairs
Number of Corvairs presently owned? ____________

Year Model BodyStyle Condition
       
       
       
       
       
Year Model BodyStyle Condition
       
       
       
       
       

Would you be willing to serve in an offical capacity or as a board member? ____________ (Yes,No,Possibly)