Membership Application - New and Renewal

DACC Dues are $20.00 per year.

Print this form, Fill it in, and mail it with your check to

Detroit Area Corvair Club
Rich Blanchard
4776 Granger Rd.
Oxford, MI. 48371-3304
E-Mail Rich

Name ________________________________        Home Phone ________________________

Address ______________________________        Cell Phone _________________________

City, State, Zip ________________________________________________________________

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)