4-State Vettes
Registration

Thank you for your interest in becoming a member of 4 State Vettes! We look forward to having you participate in our monthly meetings and events. We meet the 2nd Tuesday of each month at 7:00 p.m. (dinner starting at 6:00 p) at Granny Shaffer's Restaurant at 2728 North Rangeline, in Joplin, Missouri. Our club dues are $40.00/year per Single member & $50.00/year per Couple.

Checks can be made payable to: 4 State Vettes. 

Please send your completed registration and dues to the address below. See you soon!

Please Print                               Date:____________________

Name: __________________________________Birthday:_____________

Significant Other: ________________________Birthday:_____________

Street Address: ________________________________________________

City: ________________________State: _______Zip: _______

Home Phone: (____)__________________

Work Phone: (____)______________(____)_________________

Cell Phone: (____)________________(____)_________________

E-Mail: ___________________________________________

Year/Model/Color of Corvette(s) owned: (i.e. 1963 Coupe)_______________________

Employer(s):_________________________________________________

Anniversary:_________________

Children:___________________________________________________

Grandchildren:______________________________________________

 

Mail To:
4 State Vettes
P.O. Box 2074
Joplin, Mo. 64803-2074
4-statevettes.org