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CCC MEMBERSHIP FORM
(Please complete the entire form)
General Member
Membership includes 1 or 2 adults and children less than 18 years of age living in the same household.
Name ______________________________________________ Birthday ________________________
Address _______________________________________ City ____________________________
State ______________ Zip Code ________________ Phone # _______________________________
E-mail_________________________________________________________________________________
Members Only Web Pages Access information (only if new or changing): Note: User Name and password are case sensitive and must be a minimum of 4 characters each. User Name________________ Password _____________.
Vehicle Info: (only list show vehicles 11 years old or older): ________________________________________________________________________________________
Spouse ____________________________________________ Birthday ____________________________
Anniversary ___________________________________________________________________________
Child under 18 Birthday _____________________________
Child under 18 Birthday _____________________________
Child under 18 Birthday _____________________________
Check here for RENEWAL ONLY _______ (Please complete the entire form)
General (per year) Membership runs January 1 – December 31 (1/2 price after July 1st.)
New Membership = $30.00 _____ Renewal by January 15th = $25.00 _____ Renewal by December 31st = $20.00 _______
Signature ___________________________________________ Date ___________________________
Make checks payable to: CLASSY CRUISERS CLUB and mail to:
CLASSY CRUISERS CLUB
Membership Enclosed
PO BOX 3122
BETHLEHEM PA 18017
Note: All New members/memberships must be pre-approved by a majority vote at the next monthly meeting after receiving application.
Optional Information on back side:
This information is optional. It will be used on your photo page and/or in the newsletter.
Provide the following information for each club qualified vehicle: (Provide a photo or two, especially if there are none on our website already)
Vehicle: yr, Make, Model) _________________________________
Engine Description: ______________________________________
Paint Description: ________________________________________
Additional Information: (Anything you want to tell about the vehicle. When you bought it, how long you had it, what you’ve done to it, awards, best/worst experience, etc) _______________________________________
Provide separate pages if needed.
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