L.I.C.O.A. - Corvette Show Generic Entry Form
All entrants must complete and sign entry form. Please complete all applicable Sections, please print clearly.

Show Name:______________________________________ Date of Show:______/______/_________

Name:____________________________________________A/C Phone:________________________

Address:____________________________________________________________________________

City/Town:_________________________________________________State:______Zip:__________

Club Affiliations:____________________________________________________________________

Are you a CURRENT LICOA member?_________ If yes, are you working at this show ?_______

Are you being judged ?_____ Mail back judging sheets ?_____ (If yes; add $2. postage & handling)

Total entry fee enclosed:_____________ Check Number:__________ Dated:________________

Year of car:___________ Body Style:__________ Color:__________ Mileage:_______________

Plate Number:__________ Cubic In:_________ Approx H.P.:______ Transmission:__________

List Vehicle Modification, Alterations or Restorations to Body, Interior, Engine, Mechanical

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Requested Division ( Circle only ONE of the numbers on the left. )
0 Original Street Driven Stock Car must present a reasonably stock appearance, must be registered, car must show substantial evidence of actual street use and must have a minimum of 15,000 miles.
1 Restored Street Driven Stock Car must present stock appearance, must be registered, car must show some evidence of street use and a minimum of 5,000 miles or show evidence of restoration.
2 Concourse Stock Car must present pure stock appearance, need not be registered, must show evidence of restoration or have less than 5,000 miles for new stock vehicles.
3 Modified Stock Must have some modifications from stock, alterations must be of essentially a 'bolt-on' nature, car need not be registered and there is no mileage requirement.
4 Custom Car should show significant alteration from stock, changes may be mild or wild, car need not be register and there is no mileage requirement.

Note: Your vehicle may or may not be placed in the requested division based on the examination and determination of the qualifying judge. Any objection to your classification must be placed with the senior judge prior to the close of registration. No car will be entered or reclassified for judging after the official close of registration. * Engine compartments are not judged in either of the street driven division. Entrants have the option to bump up one division within their category (see the senior judge). If you are a member and would like to train as a class judge see the senior judge prior to the close of registration. Only trained and qualified members may act as class judges.

I hereby release Long Island Corvette Owners Association and the host(s) / sponsor(s), all officers and officials from any and all responsibility for my vehicle while at this show.

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Applicant Signature (Required) Date
An application with a signed release must be completed and on file for all cars.
If you're being judged; your entry fee (see fee schedule elsewhere) must be included with this application.
There is NO FEE for a member's 'Display Only' vehicle.
Do not send cash; make checks payable to the Long Island Corvette Owners Association.
Mail completed application and entry fee to the address shown above.
Pre-registered entries must be received at the P.O.Box at least 7 working days (Mon. to Fri.) prior to the show.

Long Island Corvette Owners Association
Corvette Show Entry
P.O. Box 191
East Meadow, NY 11554-0191