New Member Form - The Vintage Car Club

New Member Application Form

"*" indicates required fields

Phone

This field is for validation purposes and should be left unchanged.

Security Information:

Your Application Information is safely transmitted with encryption automatically
All personal information will be excluded from the Club’s Membership Directory with the exception of your name, email address, vehicle(s) listed, and membership term end date.
The Membership Directory is posted to the Members Only page on the website and will not be shared outside of VCC Membership
The On-Line Dues Transaction is conducted by PayPal, a Nationwide OnLine Secure payment system
- PayPal accepts payment from PayPal account holders or ANY major credit card
- You DO NOT NEED A PAYPAL account … you can use your credit card
- The VCC club and/or its Treasurer DOES NOT HAVE access to your credit card information
- You will receive a receipt email from PayPal and a confirmation email from the VCC

Application is for New Members and Associate Members only:*

(Associate Member must reside in the same household of the VCC member and term chosen by the Member shall apply to the Associate Member without deviation.)

CONTACT INFORMATION

MEMBER

Member Name*

First Last

Member Address*

Street Address City State ZIP Code

Member Email*

Member Home Phone*

Member Cell Phone*

ASSOCIATE MEMBER (must reside in the same household as the VCC Member )

Associate Member Name*

First Last

Associate Member Address*

Street Address City State ZIP Code

Associate Member Email*

Associate Member Home Phone*

Associate Member Cell Phone*

VEHICLE INFORMATION (optional)

Vehicle #1 Make:

Vehicle #1 Model:

Vehicle #1 Year:

Vehicle #2 Make:

Vehicle #2 Model:

Vehicle #2 Year:

Vehicle #3 Make:

Vehicle #3 Model:

Vehicle #3 Year:

Total Dues:

Finish and Proceed to PayPal.
Click the SUBMIT button below to proceed to Paypal to pay the dues.
Once you have paid via PayPal or your Credit Card you will automatically become a member of the VCC.