Join G.A.C.C.

	Gateway Area Chevelle Club Membership Registration Annual dues are $25. Fill out the form and submit now, then drop your check for first years dues in the mail tomorrow. If you prefer, you can pay with your credit card by calling (314) 785-6120 x206.

PERSONAL INFORMATION:

* = Required

Name:

(Primary Member) *

Spouse/other:

(Families are included)

Address:

(Required to receive newsletter) *

, *

Phone:

e-mail:

Personal web site:

CAR INFORMATION: (if more than one car, please submit additional forms)

Year:

Model:

V.I.N.:

(Optional)

Category (check one)

Original

Restored Original

Restored Modified

Street Rod

Daily Driver

Engine(CI):HP: Transmission:

Options (check all that apply) PS PB A/C PW Tilt

Please specify other significant details:

OPTIONAL INFORMATION:

How long have you owned your car?:

Occupation:

Employer:

Work Phone:

Member of:

A.C.E.S.

N.C.O.A.

Other:

Other cars,
hobbies, etc.:

Are you able to assist with the operation of the club:

If so, please state a best time and number to contact you:

Thanks!

or
Print and mail to:

Gateway Area Chevelle Club, Inc.
Attn: Membership
4350 Rider Trail North
St. Louis, MO 63045