Membership

Northern California Region—Classic Car Club of America


You do not need to own a classic car, but do need to have an interest in them, to be a member of NorCal CCCA. To apply, print and fill out this form. Use this form for both new and renewal membership applications. Dues for NorCal CCCA are $30.00 per year, January through December.

Include your check payable to NorCal CCCA and mail with this completed application to Bob Fracolli atpostal address or .



Name:

(   ) Current membership in the National CCCA is required for membership in NorCal CCCA. Please confirm that you are a current member of National CCCA by checking here.

(   ) Liability insurance is required for all vehicles brought to CCCA events. Please confirm that you maintain liability insurance for your participating vehicles.


Signature:
Date:

(   ) For renewals, if there are no changes to your current listing in the directory, please check here and skip the rest of this form.

Spouse:
Street:
City:
State:
Zip:
Phone (day):
Fax:
Phone (night):
Email:

CHANGES TO CURRENT DIRECTORY VEHICLE LISTING? Please note if vehicle is to be ADDED or DELETED. Only add vehicles approved by the Classic Car Club of America. Please note Make, Year, Number of Cylinders, Model or Series, Body Style, and Body Maker (if custom body). Use back of this form or additional sheets as necessary.

  2012-08-10