Mazda Club Application

TO JOIN (or renew) ONLINE WITH CREDIT CARD ON OUR SECURED SITE CLICK HERE!
or use our PayPal and Credit Card Order Form
membership benefits (A membership application in Adobe Acrobat (.pdf) format is available by clicking here)
Membership items: click here for a change of address, click here to add or change a car registration or click here to add a shop recommendation

Fill out, print out and then mail or FAX:

MAZDA CLUB APPLICATION FORM (new memberor renewal)
NAME: (memb no. if renewing):
MAIL - STREET ADDRESS:
CITY - STATE- ZIP
COUNTRY (if not U.S.A.)
PHONE(S): Home: FAX: Other: email: (needed for eOnlyWay)
One Year					$30
Two Years					$55
*Three Years (with free t-shirt or tech CD)**					$80
One Year (Outside the U.S.A.)					$35
Two Years (Outside the U.S.A.)					$65
*Three Years (Outside the U.S.A. with free t-shirt or tech CD)**					$95
One Year eMembership (receive eOnlyWay and access to Members Only section of website which includes online OnlyWay, tech staff contacts, etc., no membership materials sent via regular mail - this is included with all other memberships)					$20
*Two Year eMembership* (see above for information)					$35
Three Year eMembership (with free t-shirt or tech CD*) (see above for information)					$50
You may pay using your credit card: (charge will be to National Firebird Club)		Visa	MasterCard	Discover	American Express
(if using PayPal state for what you are ordering or hit your browser's back button to continue to fill in this form with all but credit card info, PayPal to orders@mazdaclub.com ) or use our PayPal and Credit Card Order Form
Credit Card No: Expiration Date: Security Code: (email address required above if using credit card)
NEW! Technical Sections ($10 + $ 5 S&H) - *copies of tech topics published from 1998 to 2007 by MC, indexed, on CD-Rom* only in pdf format for PC or Mac**
We accept check or money order payable to the Mazda Club in U.S. funds only. Return this application and enclose payment info to : Mazda Club P.O. Box 11238, Chicago, IL 60611 U.S.A. or FAX: (773) 769-3240 TO JOIN (or renew) ONLINE THROUGH OUR SECURED AREA CLICK HERE! or use our PayPal and Credit Card Order Form Comments or other instructions:
OPTIONAL INFORMATION Note: The ownership of an Mazda IS NOT a prerequisite for active membership. If a Mazda is owned, you may want to fill out the form below:
Year	Serial # (VIN)		Model	Color


THE FOLLOWING ARE ALL OPTIONAL INFORMATION:
Areas of interest:
Service, body or parts shop info (include type of business, person to contact, address and phone number):
Send picture and/or story about car:
How did you first learn of the MC?: