*
indicates required field
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Member Applicant * |
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2nd Applicant (if
any)
spouse/partner/relative |
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Address |
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Postcode |
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Home Phone |
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Mobile Phone |
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Work Phone |
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Email * |
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Occupation |
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Interests / hobbies |
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Birthday |
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2nd applicant Birthday |
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Activities of Interest
(check all that apply) |
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Do you currently
own a Corvette? |
Yes No |
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Are you looking for one? |
Yes No |
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Year |
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Body Style |
Coupe
Convertible
Hard-Top |
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Exterior Colour |
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Interior Colour |
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Engine |
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Transmission |
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Owner Since |
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Additional Information
eg. options modifications /
vehicle history / story) |
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Print this document
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