First Name:

Last Name:

Spouse/Significant Other/Domestic Partner:

Street Address:

City:      State:      Zip:

Cars:  Model                      Make             Year           Color

Email Address:

Comments:

Cost of membership is $24.00 per year pro rated based upon the month you join.  Here is the cost: Jun and Jul $24, Aug $22, Sep: $20, Oct: $18, Nov: $16, Dec $14, for persons joining in the months of Jan through May the amount includes the annual renewal of $24.00 with the pro-rated amount for the remainder of the current year. Jan: $36, Feb: $34, Mar: $30, Apr: $28, May: $26. Please  fill out this membership application, print it and mail to KCMGCC, PO Box 388, Smithville MO 64089-0388.  with your check. Checks should be made out to KCMGCC..

We will acknowledge receipt of your application via e-mail and send you out the next newsletter with your membership card.

Thank you