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Monthly Meeting Social Hour/Dinner Starts In:

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0

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9

9

Days

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5

5

Hours

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4

4

Minutes

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First Name

Middle Name

Last Name

Email

Username

Password

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NCCC Number

Physical Address

Address Line 2

City

State

Zip Code

Phone Number

Cell Phone

Birth Month and Day only

Club Affiliation

Year Joined CKCC

Email

Volunteer Committes

Volunteer Events

Dual NCCC 2

Youth Sponsor

Mailing Address if different from Physical Address

Mailing Address if different from Physical Address

Spouse/Partner Phone

Spouse/Partner Full Name

Spouse/Partner Last Name

Spouse/Partner First Name

Spouse/Partner Email Address

Spouse/Partner Birth Month and Day

Spouse/Partner NCCC #

Car Year

Car Model

Car Color

2nd Car Year (if any)

2nd Corvette Model (if any)

2nd Car Color (if any)

Car Year 3

Car Model 3

Car Color 3

Mail City

Mail State

Mail Zip Code

Dual NCCC 1

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