THE LONE STAR CHAPTER
of the
Buick Club of America

 MEMBER INFORMATION FORM

 (only name and any changes for renewals)

Name/Spouse                                                                                           BCA no:_____________________________
Address :_________________________________________________ E‑mail:______________________________
City / State / Zip‑___________________________________________ 10 Digit Phone:________________________

Tell us about your cars:

 year                             model no                 model name                   body style               condition (1‑6)
_______                       __________               ____________                 ___________           _____________
_______                       __________              ____________                  ___________           _____________
_______                       __________              ____________                  ___________           _____________

 
Tell us about your good or bad luck with Vendors (scale: 10 = great; 0 = not so)

_______________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

 
Tell us what you want to do (shows, tours...maybe a specific event not on our calendar).

_______________________________________________________________________________________________

______________________________________________________________________________________________

You must be a member of the BCA to join our local Chapter. BCA info is available on request. Local dues are only $15.00 per calendar year. Make check payable and mail to:

LONE STAR CHAPTER, BCA
5112 Arrowhead Drive
Baytown, TX 77521