North Star Chevelle Club

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Name

Address

Phone Number

Year/Make/Model

Description of your car(s)

Member status

New Member

Former Member

Renewal

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Discussion Forum Handle/Nickname

Do you have an interest in being an Officer of the Club?

Yes

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Would you be interested in helping with a newsletter, Club events, or Merchandise?

Yes

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Membership dues received between Jan and June are $30 per year; dues received between July and December are only $15.

Enclosed $30

Enclosed $15

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Please send check/money order and completed application form to:

Northstar Chevelle Club

257 Plainview Drive

River Falls WI, 54022

Thank you and see you at the meetings!!!

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