Join Form

The Corbitt Preservation Association
Registry and Membership Application

To join the Corbitt Preservation Association please print this page, fill it out and mail with your check
(payable to The Corbitt Preservation Association) to

Corbitt Preservation Association
PO Box 74
Henderson, NC 27536

NAME:_____________________________________________________________________________

ADDRESS:__________________________________________________________________________

CITY:_______________________________ STATE:_____________________ ZIP:________________

PHONE:______________________________________ DATE:________________________________

EMAIL:____________________________________________________________________________

The $ 15.00 association membership fee (as of 2010) is due annually at the February meeting.

New members paid after the October Corbitt Truck Reunion in Henderson will be paid

for the following year.

We would like to keep a registry of Corbitt trucks owned by our members. You do not need to own

a Corbitt truck or tractor to be a member in the Corbitt Preservation Association.

Year Model Serial # (if known) Body Style

___________________________________________________________________________________