North Texas Corvair Association

P.O. Box 170796

Irving, Texas  75017-0796

      

 

                                         MEMBERSHIP APPLICATION

 

 

The North Texas Corvair Association (NTCA) is an association dedicated to the preservation and

enjoyment of the Chevrolet Corvair. We are chapter #750 of the Corvair Society of America (CORSA).

 

To apply for membership: Please print out the following form. Fill out the application and mail it to the

above address. Please make your check or money order payable to North Texas Corvair Association. Thank

you.

 

      First Name: ___________________               Last Name: ______________________________  

 

      E-mail: _______________________               Spouse:  ________________________________

 

      Address:   ____________________________________________________________________

 

      City, State, Zip: ________________________________________________________________

 

      Home Phone:  _______________________    Work: Phone _____________________________

 

      Cell Phone: ________________________

 

      Sponsor:__________________________

 

Please list the address to which the newsletter will be sent. Any phone numbers entered will be listed in the

roster unless you indicate otherwise.  We do not make the roster available outside the club.

 

      Occupation: _________________________     

 

      Corvair(s):

      ____________________________________     ______________________________________

 

      _____________________________________   ______________________________________

 

NTCA provides a discount applied to dues for members of CORSA. NTCA club dues are $18.00 per year

for CORSA members and $20.00 per year for non-CORSA members. CORSA dues are $38.00 per year. If

you are a member of CORSA, please include your member number: ______________________________

 

      NTCA Membership Dues: $  20.00        

 

      Less CORSA Discount: $__________

 

      Total: $__________

 

      Support NTCA - join CORSA!