Personal Information: Please fill in completely

How did you find out about the C5/C6 Registry:
Select One Another Member At an Automotive Event In a Magazine Internet

This is to apply for:
Select One New Membership Membership Renewal International Membership

   Current Member Number
( Enter your member number if you are updating your registration.)

Your Full Name:

Name Printed on Badge:
 
 This will be the name listed on your C5/C6 Registry Name Badge

Your Full Names for additional badges
(Please Add $8.00 Per Additional Badge:)
 

Mailing Address:

City: State: Zip:

Country:

Day Phone: (Example 7015551234)  
Evening Phone:  (Example 7015551234)  
Fax:  (Example 7015551234)   
No punctuation or spaces in phone numbers

E-Mail:*                

*Please list your full E-Mail Address ie: JohnPublic@AOL.com   if it's not listed,
we cannot respond to your registration. Thanks!

Occupation: Optional

Please Select: This is My First Corvette 1 Before This 2 Before This 3 Before This 4 Before This 5 or More Before This One

Please Select: Select One - NCM Membership I am a member of The NCM Not a member of the NCM

Year:  Date Of Purchase:   Original Owner:

Dealer Name:

Dealer Address:

Complete VIN Number:

Model: Coupe FRC Convertible Z06 Indy Pace Special Edition   Convertible Top Color: N/A Shale Blue Gray Black White Lt. Oak Beige

Roof Panel: Standard Blue Dual N/A Exterior Color: Precision Red Fairway Green Metallic Speedway White victory Red Monetry Red Magnetic Red Metallic II Crystal Red Metallic Black Arctic White Jet Stream Blue LeMans Blue Metallic Machine Silver Metallic Millennium Yellow Velocity Yellow Tint Coat Carbon Flash Metallic Cyber Gray Metallic Medium Spiral Gray Blade Silver Metallic Quicksilver Sebring Silver Metallic Light Pewter Metallic Aztec Gold Inferno Orange Metallic Pace Car Purple Medium Purple Pearl Metallic Carlisle Blue Metallic Electron Blue Metallic Jetstream Blue Metallic Tintcoat Nassau Blue Metallic Navy Blue Metallic Navy Blue Metallic Supersonic Blue Metallic Anniversary Red Light Carmine Red Metallic Torch Red Victory Red Precision Red Dark Bowling Green Metallic Daytona Sunset Orange Metallic Atomic Orange

Interior Color: Cashmere Colbalt Red Ebony Steel Gray Titinium Gray Red/Ebony Cashmere/Ebony LT4 Linen\Ebony LT4 Sienna/Ebony     Axle Ratio: GU2 (2.73) With MXO G90 (3.15) Performance GU6 (3.42) With 6 Speed