Central Illinois Camaro Club Membership Application
Please enter your information as completely and accurately as you can.
Please provide the following contact information:
Name Title Organization Street Address Address (cont.) City State/Province Zip/Postal Code Country Home Phone E-mail URL
Please provide the following ordering information by typing your initials in the quantity box:
QTY DESCRIPTION SHIPPING Street Address Address (cont.) City State/Province Zip/Postal Code Country
Choose one of the following options to confirm your membership option:
One year membership Six month membership Quarterly Membership