Untitled Document

Application for Membership - Registry of Corvette Race Cars

Name E-mail

Street City State:

Country (if not USA): Zip: - Telephone

Please check appropriate boxes. All information must be completed.

1. I hold or have held a recognized competition license.

Y , N

IF YES, PLEASE SELECT:

SCCA Club , SCCA Pro , IMSA , Grand-Am , FIA , Vintage

2. I have completed a recognized competition driving course.

Y , N

IF YES, PLEASE SELECT:

SCCA , Bondurant , Barber , BSMR/Russell , Roos , Other

3. I have entered one or more races in the last 12 months.

Y , N

4. I have completed a club track day school.

Y , N

5. I have crewed or attended a race in the last 12 months.

Y , N

6. I own or have owned an authentic Corvette race car.

Y , N

IF YES, PLEASE ENTER:

Year Race Series Year Race Series

Year Race Series Year Race Series

7. Mark all interests that apply

C1 , C2 , C3 , C4 , C5 , C6

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