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Classic Buick Club of Switzerland |
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| I will be a member of the Classic Buick Club! | ||||
| Annual fee SFr. 100.-- / US $75.00 / EURO 65.-- | ||||
| Payment by PayPal only for non Swiss residents! You will get the informations after your registration! | ||||
| Fields with red stars have to be completed! | ||||
| Name | ||||
| First Name | ||||
| Name Wife | ||||
| First Name Wife | ||||
| Adress | ||||
| Postal Code | ||||
| Town | ||||
| State | ||||
| Telefon | ||||
| Fax | ||||
| Confirmation Joining | ||||
| Information by |
| Make | Modell | Modell Code/Type | Year | VIN/Chassis No. | Motor
No. |
Motor
Code |
| Buick | ||||||
| Transmission | Steering | Windows | Radio | Color ourside | Trim
color |
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| Colorcode | Roofcolor | Accessories Code | Trim Code | Condition | ||
If possible send one or two pictures of your Buick! (*.jpg or *.gif,
max. size 100KB)
Thanks!
Remarks:
(Please fill all fields with the red star!)