THE COUNTRY CRUISERS

APPLICATION FOR MEMBERSHIP

 


   Name: ___________________________
 

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

   City: _________________________     State: _________   ZIP: ____________

   Phone (Including area code) : ________________________________________

   Email: __________________________________________________________

   Vehicle Year: _______   Make: ____________________   Model: ___________


.............................. Clip and Keep Bottom Half if you like ...............................


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 beginning January 1 and ending on December 31st.
.
Make checks payable to:
THE COUNTRY CRUISERS CAR CLUB, INC.
PAT CORNELL
6446 ROSETTA DRIVE
BURLINGTON, KY. 41005


Upon receipt of your membership dues, a newsletter will be sent after each scheduled meeting.

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.