NSCM Name Badge Form   New Order Name Badge Pricet $ 9.00 Each Make Check Payable to: NSCM Forward form and check to: North Shore Corvettes of Mass P.O. Box 2212 Methuen, MA 01944   (Please print as clearly as possible) Line #1: _______________________________________________ Line #2 (Optional): _______________________________________ (Please print as clearly as possible)   Member Name (First Name): _______________________________________________________________________ Member Name (Last Name): _______________________________________________________________________ Address: ______________________________________________________________________________________ City: ______________________________________________________ State: ________ Zip Code: _____________ Phone Number (with area code): _______________________________ Cell: ________________________________ Email Address: _________________________________________________________________________________