2009 Membership

   ( Annual Dues ONLY $10 )

 

 

 

Name(s): __________________________________________________

 

 

Mailing Address: ___________________________________________

 

City: _________________________________

 

State: ________________________________                                           

 

Zip Code: ______________          Phone: (______) _________________

 

 

E-Mail: _____________________________________________________

 

National ID #______________

 

I own the following Cadillacs and/or LaSalles

 

Year

Make

Body Style

Model

 

 

 

 

 

 

 

 

 

 

 

 

 

Names as they should appear on your name tags:

 

1.  ______________________________________________

 

2.  ______________________________________________

 

Please forward your completed application with a check for $10.00, payable to CRCLC: To: Membership  Attn: Jay Ann Edmunds, 1441 Kestrel Court, Lenoir, NC  28645