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        ENROLMENT   FORM

       
1. Name :
             
2. Address - Residence :    Phone :
         Email :
           
             
3. Address - Official :    Phone :
         Email :
     
4. Present vehicles'    
      Registration number :
      Engine number :
      Chassis number :
      Horse power :
      Year of manufacture :
      Drive side :
       
5. Previous beetles if any :  [ Registration number ]
       
6. How long you have been a beetle owner :  [ #of years ]
       
       
       
       
  Date:     Signature:...............................................
       
       
     
Enrolment fee : Rs. 200/=
Life membership fee : Rs. 1200/=
Annual membership fee : Rs. 200/=

Please issue a Ceeque / Money order / Postal order in favour of "VW BEETLE OWNERS' CLUB"