Join the BUICK CAR CLUB OF AUSTRALIA INC. (Qld.)

Use either the off line (download, print and post) or the online form below.

Offline Member Sign Up
Click here to download PDF Form
Post to Buick Car Club of Australia Inc. (Qld.) 1367 Old Cleveland Rd, Carindale. Q 4152. E-mail to Secretary: adearling@bigpond.com

Payment Options

Post cheque with application or direct debit with reference your surname to
Heritage Bank
BSB 638070, A/c # 8428328
A/c Name – Buick Car Club of Australia Inc.

ONLINE MEMBERSHIP APPLICATION FORM

BUICK CAR CLUB OF AUSTRALIA INC. (Qld.) ( This application form once submitted may take up to 14 days to process and to receive your confirmation of acceptance pack.)
Complete the form below. Items marked * are required.
Surname *
Given Name *
Spouse / Partner
Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Contact Number *
Email
Date *
Annual Membership
The club year runs from 1st July to 30th June and all members joining mid-term will receive back issues from July of the monthly Buick News in pdf form by e-mail.
The Club holds Public Liability insurance to $10M.

The Joining Fee is $5.00
New members tick one$70 including posted printed copy of monthly Buick News magazine$45 including e-mail copy of monthly pdf Buick News magazine
Membership Renewal Fees
Continuing members tick one$65 including posted printed copy of monthly Buick News magazine$40 including e-mail copy of monthly pdf Buick News magazine
Payment Method *Indicate how you intend to pay fees.

Buicks Owned:

(Ownership is not a prerequisite for membership.)

Year

Model

Body Style

Chassis No

Engine No

Rego No

Condition

Year

Model

Body Style

Chassis No

Engine No

Rego No

Condition

Year

Model

Body Style

Chassis No

Engine No

Rego No

Condition

How did you hear about the Buick car Club?

Ad in car journal/magazine

Existing member (if so, who):

Attendance at a car show:

Other

Agree to Join I do hereby make formal application to join the Buick Car Club of Australia Inc. (Qld.)
Electronic submission is regarded as signing.
Fill in the Anti Spam check below and click submit.

Section

Anti Spam

Please enter any two digits with no spaces Example: 12 *
This box is for spam protection - please leave it blank:

Buick Car Club of Australia Inc. (Qld.)

For lovers of Buicks

Membership Application Form

Join the BUICK CAR CLUB OF AUSTRALIA INC. (Qld.)

Payment Options

ONLINE MEMBERSHIP APPLICATION FORM

Buicks Owned:

How did you hear about the Buick car Club?

Section

Anti Spam