CENTRAL INDIANA CAMARO CLUB

Membership Application

 *** Print out and mail in with your check ***

Name:  _________________________________

Address:  ________________________________

City:  ________________________

State:  __________

Zip:  ___________

Home Phone:  _______________________________________ 

Work Phone:   _______________________________________

E-mail Address:  ______________________________________ 

Camaro(s) owned:______________________________________

Special Features:_______________________________________

______________________________________________________

Spouse (if applicable):___________________________________________

Children’s Names (if applicable):_________________________  _____________________________________________________   

Tee Shirt Size: ________________________________________

 Membership dues are $20.00 per year.  Mail application and check, payable to:

Central Indiana Camaro Club

P.O. Box 90236

Indianapolis, Indiana 46290-0236 

_______________________________     ___________

Applicant’s Signature                                                        Date

                       Questions? Call: Steve Ellis (317) 946-7731