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

Personal Details

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.

Submit your form then pay by EFT using the details below:
Account Name: Chrysler Club SA
BSB: 065 145
ACCOUNT NO: 0090 1064
Amount Owing: $50.00
Please include your name and membership number (if you are an existing member) in the payment reference.

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.