THE COUNTRY CRUISERS

APPLICATION FOR MEMBERSHIP

2017

 


   Name: ___________________________
 

      Date of Birth: ______________
 
   Spouse: __________________________
 
      Date of Birth: ______________
 
   Address: ________________________________________________________

   City: _________________________     State: _________   ZIP: ____________

   Phone (Including area code) : ________________________________________

   Email: __________________________________________________________

   Vehicle Year: _______   Make: ____________________   Model: ___________

 


The Country Cruisers Car Club, Inc, was organized in 1990 for family-oriented entertainment for all car enthusiasts.  It is a non-profit organization that promotes charitable work and wholesome activities.

Monthly meetings are held on the first Tuesday of each month and numerous club activities are held for the entire family of the members of the Country Cruisers.  There are NO ALCOHOLIC beverages or reckless driving permitted at any of our club functions.

Family membership dues are $20.00 per year if prepaid between 1 October and 31 December each year or $25.00 if paid after 1 January each year.  Membership is January 1 and ending on December 31st.
.
Make checks payable to:
THE COUNTRY CRUISERS CAR CLUB, INC.
GERRY BLENKE
949 COLLINS ROAD
VILLA HILLS, KY. 41017


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This part goes to the Treasurer:

Name __________________________________________  Spouse ________________________________

Phone ________________________________  Email ____________________________________________

Amount Paid by Check --------------------- # ---------------- Cash ----------------------------

This application is available for you to become a member of the Country Cruisers.
Just fill it out and drop in the mail or bring it to the next meeting.