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New Membership Application Form

BUICK CAR CLUB OF AUSTRALIA INC. (QLD)

 

New Membership Application Form

 

This form may be filled out electronically and submitted or printed out from the website and filled in manually. If printed out, the form needs to be signed at Section 4 and then mailed to the Club. Details at bottom of form.

For payment options refer to Section 5 of the form.

 

1. Joining Fee Payment

 

a.      New Membership Joining Fee monies must be sent to the Club with or on the same day as the submission of your off-line application.

b.      New membership cannot be progressed unless the Joining Fee monies are received into the Club’s bank account.

c.      If the application does not proceed the Club will reimburse the monies paid.

 

2. New Members Fees [Select Option 1 OR Option 2]

Membership
Option 1
Option 2
Emailed PDF copy of Magazine
Printed/posted copy of Magazine
Joining Fee
$5.00
$5.00
12mths Membership Fee
$40.00
$40.00
12mths Buick Magazine Fee
Included
$35.00
Total Monies to be Sent
$45.00
$80.00
  1. New Member Information Required


All sections marked * must be completed

  1. Buick(s) Owned

(Buick Ownership is not a prerequisite for membership)

No 1.

Condition (Select One)
Original
Restored
Under Restoration
Awaiting Restoration
Parts Only

No. 2

Condition (Select One)
Original
Restored
Under Restoration
Awaiting Restoration
Parts Only

No. 3

Condition (Select One)
Original
Restored
Under Restoration
Awaiting Restoration
Parts Only

No. 4

Condition (Select One)
Original
Restored
Under Restoration
Awaiting Restoration
Parts Only
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5. Payment Methods

For Off-line New Membership, pay Joining Fees:

 

Please arrange payment of:

Member + PDF copy Magazine

$45.00

OR

Member + Printed copy Magazine

$80.00

 

Pay by either of the following 2 options:


 

A. [PREFERRED] Joining Fee monies can be electronically sent via Direct Debit to the Club’s Bank Acct:

Bank: National Australia Bank (NAB)

Acct Name: Buick Car Club of Aust. Inc

BSB: 084 961

Acct No. 918077925

Please:

  1. Include your “Surname” & “Application” with your electronic Direct Debit: and

  2. Fill out form above and press SUBMIT button OR Scan and sign a copy of Section 1-4 and email to Treasurer at: davejohnwilson@bigpond.com OR

  3. (NOT PREFERRED) Post signed copy of Sections 1-4 to:

 

Buick Car Club of Aust. Inc. (Qld)

1376 Old Cleveland Rd

Carindale QLD 4152

 

OR

 

B.  If you do not do “Internet banking”:

Please go to your bank and have them transfer the monies for you.

 

OR

 

C.  Pay monies by Money Order (Not Preferred):

(Cheques no longer accepted by our bank, Do NOT send)

M/O Payable to: Buick Car Club of Aust Inc. (Qld)

Please Post:

  1. Money Order: and 

  2. Signed copy of Sections 1-4: 

both to:

Buick Car Club of Aust. Inc. (Qld)

1376 Old Cleveland Rd

Carindale QLD 4152

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