Membership Form

Applicant's Name*:

Partner's Name:

Home Address*:

Phone (home)*:

Phone (work):

Phone (mobile):

Email*:

Member Category*:

Your Mercedes-Benz Cars (model, year, colour, & reg. no.)*:

Applicant's Agreement*:

 I Agree

Contact Us

The Secretary
MB Classic Car Club Inc.
distribution.mbccc@gmail.com