New Membership Application
Print this form and mail with your check or credit card information to the address below.
   Active  (USA): $55.00       Canada & Mexico:$70.00 (USD)       Other Foreign: $80.00 (USD)
Associate of active member only :    $10.00
Make checks payable in U.S. Funds.     Life Membership available after 10 years Active Membership

Name:_______________________________     Associate Name:___________________________
Address:____________________________________________________________    
City:__________________ State:_____ Zip:________   Country:______________
Home Phone:(____)___________________      Office Phone:(_____)_____________________
FAX:(_____)__________________________    Email:__________________________________

Enter below Classic Cars you own with complete description.  It is not necessary to own a Classic car to enjoy membership in CCCA.  Cars for which complete descriptions are not provided will not be listed in the Roster.  Cars must be CCCA-approved Classics, 1925-1948.  See "What is a Classic" elsewhere on this Web Site.   If additional space is needed, please use the back of this form.

* Premier, Senior, and Primary First Place Winners at CCCA Grand Classics or the Annual Meeting list Senior number.  If the number is unknown, please furnish owner's name when the car became Premier, Senior or Primary Winner and/or former owner.  Make Check Payable in US Funds to CCCA and mail with this application to:

CLASSIC CAR CLUB OF AMERICA          q My Check is enclosed
1645 Des Plaines River Road, Suite 7A             Charge to: 1645 Des Plaines River Road, Suite 7A             Charge to: q MasterCard  q Visa Visa
Des Plaines, IL  60018-2206                                 Sign below and return with your check or charge info.
Phone (847) 390-0443
Fax: (847) 390-7118