Membership Information

For membership please provide the following contact information and we will get back in touch with you:

First Name
Last Name
Middle Initial
Wife or Significant Other
Year of Corvette
 Type of Corvette
Street Address
Address (cont.)
Zip/Postal Code
Work Phone
Home Phone
His Cell Phone
Her Cell Phone

His E-mail

Her Email

If this is your first year of membership, then paying your membership will include club nametags. Send your check for $25, to:

Caney Valley Corvette Club
C/O Tonya Leeson
P.O. Box 203
Bartlesville, Okla.  74005