Membership Application/ Information Update

                         Date_______________         

Name_________________________________________________________

Last                                                 First                        MI

Spouse/Significant Other_________________________________________

                                      Last                                First                               MI

Address_______________________________________________________

City________________________________________ Zip_______________

Home Phone ______________Bus ________________Cell ______________

E-mail Address_________________________________________________

Birthday ______________Spouse/Significant Others B'Day _____________

Anniversary___________   ** Year for birthdays & anniversary not required

                          Name to be printed on membership card ____________________________

                           ___ Yes ___ No Please check Yes if it is OK to put your Name & Phone

                          number on a list to be distributed to other TBV club members ONLY.

Corvette#1 Color ____________ Year ___________ Body Style_________

Corvette#2 Color ____________ Year ___________ Body Style_________

Corvette#3 Color ____________ Year ___________ Body Style_________

If you have more than three please use additional pages as necessary

Attach a check payable to Tampa Bay Vettes Inc. for $25.00

Note: Renewal memberships are $25 annually

Frank Crawford Membership Chairman

615 Lithia Pinecrest Rd.

Brandon, FL 33511

Meetings at: Ferman Chevrolet, 9751 Adamo Drive, Tampa FL 33619