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Membership Application Form
Home
Membership Application Form
MEMBERSHIP APPLICATION FORM
Membership registration
Step 1 of 3
33%
A. Personal Information
Name
*
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
Prefix
First
Last
Gender
*
Male
Female
Marital Status
*
Married
Single
Mobile
*
Email
*
Nationality
*
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Greenland
Grenada
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Sudan, South
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Yemen
Zambia
Zimbabwe
City/Emirate
*
Date of Birth (D/M/Y)
*
P.O. Box
Emergency Contact Name
Emergency Phone No.
Instagram
Facebook
B. Vehicle Information
Car Model
*
Granturismo
Granturismo MC
Grancabrio
Grancabrio MC
Ghibli
Ghibli S
Ghibli 4Q
Quattroporte
Quattroporte GTS
Gransport
Levante
Levante S
Other
If other, Please specify
*
Other (Specify)
*
Year
*
Color of your car
*
White
Black
Red
Yellow
Blue
Green
Orange
Purple
Gray
Pink
Navy
Brown
Maroon
Plate Source
*
Abu Dhabi
Ajman
Dubai
Fujairah
Ras al-Khaimah
Sharjah
Umm al-Quwain
Plate Code
*
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y
Z
Plate Code
*
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Plate Number
*
Please attach a copy of the Registration Card – both sides
*
Drop files here or
Accepted file types: pdf, doc, docx, jpg, png.
C. Declaration & Release
I understand and agree to comply with the club rules and regulations. I hereby understand that failure to adhere to the rules and regulations of the club may result in my membership being cancelled by the Club at any time.
I declare that the above details are true and correct to the best of my knowledge. By signing this form, I authorize Maserati Owners Club UAE to use my data, publish and reproduce any image and/or videos taken of me and/or by me during club events and activities.
*
I agree the
rules and regulations