(Click the Membership button above to return back to WCC's Main-membership page.)
Please provide us with as much of the following information as you can remember or will divulge: (Note: Use your mouse or the Tab key to move between fields. Hitting Enter = Submit form now)
Your Name (First, Last) Street Address-1 Street Address-2 City Province/(State) Postal Code/(Zip) Country (if not Canada) Phone with Area Code Fax (Optional) E-mail Your website URL (Optional)
How did you hear about Western Canada Corsa?
Are you a member of C.O.R.S.A.?
Yes No
If yes, how long (years)?
Which best describes your interest in Corvairs?
Transportation Restoration Modification Collection Competition
How badly are you suffering from Corvairitis? (i.e. How many do you own or store?)
Number of Corvairs you have running?
Number of Corvairs under restoration?
Number of Corvairs awaiting restoration?
Number of parts cars?
Please list the most significant Corvairs you own:
How long have you owned/been involved with Corvairs?
1-4 years 5-9 years 10-15 years 16-19 years Advanced Corvairitis
What is your current age? Are you older than your Corvair or is it older than you? (Please provide your birthday in m/d/y format or just your age in years if you are bashful.)
Which statement best describes your mechanical aptitude with Corvairs?
You change the oil how? Confident doing basic repair work Will try everything but the most complicated jobs Larry Claypool!?! He don't know nothin'!
What other "enthusiast" vehicles do you own?
Do you/have you belonged to any other locally-based car clubs in the past (for any vehicle)?
If yes, please list the names of the clubs of which you are or were a member.
What activities or aspects of Western Canada Corsa interest you most?
Camaraderie/Social aspect Technical Information Parts Information Competition, i.e. Slalom/Autocross
Camaraderie/Social aspect
Technical Information
Parts Information
Competition, i.e. Slalom/Autocross
Other?
How many hours a month would you be willing to donate to an organized chapter?
0 hours 1-2 hours 3-5 hours 6-10 hours 10+ hours
Do you possess or have access to skills or resources vital to the management of a car club? (Secretarial or bookkeeping, printing facilities, teaching abilities, web publishing etc.)
