Membership Application
Membership dues are $35.00 a year and $10.00
for your spouse.
Dues can be paid at the next club meeting and the check can be made payable to
Mid Florida Corvette Club.
Member Significant Other
NAME ______________________________ ________________________________
Address______________________________ ________________________________
______________________________ ________________________________
Email ______________________________ ________________________________
Home Phone ______________________________ ________________________________
Work ____________________________ _______________________________
Cell: _____________________________ ________________________________
Birthdate:_____________________________ Spouse’s Birthdate:________________
Car(s) Year and Model: __________________________________________
How Did You Hear About Us: __________________________________________
__________________________________________
I will email a photo of my car(s) for inclusion on the club’s website to bbkarlsson@cfl.rr.com:
Yes _____
No _____
Thank you for joining the best Corvette club in Florida!
http://www.midfloridacorvettes.com/
MAIL TO: Barbara Karlsson, 521 Rebecca Drive, St. Cloud, FL 34769