APPLICATION FOR MEMBERSHIP IN THE C.O.R.E.

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Application along with $60.00 for full membership must be submitted

at the same time or the application will not

Be processed. Mail to: CORE 7730 Dinniston Dr Huntersville NC 28078.

NAME:           _____________________________________

ADDRESS:       _____________________________________

                   _____________________________________

HOME PHONE: _____________________________________

WORK PHONE: _____________________________________

E-MAIL:        _____________________________________

DRIVER’S LICENSE #: _______________________________

STATE:        ___________ DATE OF BIRTH : ___________

VEHICLE INFORMATION:

MAKE: _____________ MODEL: ____________ YEAR: _____

LOCKERS?  YES / NO      WINCH?  YES / NO

LIFT?  YES / NO           HOW TALL?  _________________

TIRE SIZE?  ____________  CB?  YES / NO

ON BOARD AIR?  YES / NO  ON BOARD WELDER?  YES / NO

OTHER MODS: _____________________________________

                  _____________________________________

YEARS OF WHEELING EXPERIENCE: ____________________

MEMBER OF ANY OTHER CLUBS OR 4 WHEEL DRIVE

ORGANIZATIONS? __________________________________

By my signature below, I have read the CORE BY-LAWS and agree to abide

By the regulations stated within. I understand that if at any time I am in violation of any of the BY-LAWS I am subject to termination from the club.

Provided that no adverse comments on you are received from the club members, you will be granted membership in the CORE and receive notification at that time.

SIGNED: ________________________________________

                    ADMINISTRATIVE USE ONLY

REJECTED      ACCEPTED      MEMBERSHIP # _________________

NOTES: ________________________________________________

___________________________   __________________________

PRESIDENT                             DATE