Carolinas Chapter          

Buick GS Club of America

Membership Application

"Always Going Fast With Class"

Carolinas Chapter membership (includes spouse and children) offers:

• Monthly meetings

• Bi-monthly issue of club newsletter

• Free advertising in newsletter of auto-related businesses

• Participation in all club events

• Free classifieds

Membership is on an annual basis of $24.00 from September1.  New members dues are prorated at $2.00 per month.  Membership in the Carolinas Chapter DOES NOT include membership in the Buick GS Club of America (GSCA).

To begin your membership in the Carolinas Chapter, please send the completed application and dues to Carolinas Chapter c/o Karen Miller, 229 Dunlap Gate Road, Statesville, NC  28625.  Please make checks payable to the Carolinas Chapter.

Please print or type:

GSCA # __________________

Name:  ________________________________________________________________

Address:  ______________________________________________________________

City:  __________________________    State:  _______     Zip:  ______________

Phone (home):  _______-________-________       

Phone (other):  _______-________-________

E-mail:  ________________________________________________________________

                                        Year                             Body Style & Color

Buicks                    _________________                _____________________________

Currently                _________________                _____________________________

Owned                    _________________                _____________________________

                               _________________                _____________________________