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!