Membership Application/Renewal

Membership $50 per Financial Year (July 1 to June 30)

BOTH completed form AND membership fee must be received BEFORE membership will be processed.

CLICK HERE for information regarding the Club Vehicle Registration scheme

Membership Details Update

Use this form if your membership is NOT expiring and you just need to update your contact and/or vehicle details.

CLICK HERE for information regarding the Club Vehicle Registration scheme

Personal Details

Please enter your POSTAL address below. It is where you wish to receive magazines and correspondence.

You can renew your membership for up to 3 years, at $50 per year. Please check your vehicle log book expiry and align your membership to that.

years.

Vehicle Details

Vehicle 1

If vehicle currently on Club Registration scheme.
Expiry date is at top of front cover.
 

Payment

Membership will only be processed on submission of form and receipt of payment.

Our preferred method of payment is via EFT or Credit/Debit Card

Please choose your payment method:

Payment Via Electronic Funds Transfer (EFT)

Submit your form then pay by EFT using the details below:
Account Name: Chrysler Car Club
BSB: 325 185 (Beyond Bank)
ACCOUNT NO: 03872566
Amount Owing: $50.00
Please include your membership number then name (if you are an existing member) as the payment reference.

Note that our banking details above have changed. Please update any saved account details with your bank.

Please ensure you use the account name provided - Beyond Bank validate this, the BSB and Account No. to process payments

Payment Via Credit or Debit Card

We use Square as our online payment method.

Once you submit your form you will be redirected to our Square online portal to pay your membership

Square is a secure payment portal and CCCSA does not receive nor store your credit/debit card information from the transaction.

Submit your form

Please check the details entered above prior to submitting. You cannot change the form once you submit it (you will need to submit a new form).

A receipt will be sent to the email address above, including a copy of the payment instructions.