Compact Buick Club (1961-63 Special and Skylark)

APPLICATION FOR MEMBERSHIP & AUTO REGISTRY INFORMATION



Please submit the completed application to:

Compact Buick Club (1961-63 Special and Skylark)

PO Box 411, Tustin CA 92781

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The Compact Buick Club (CBC) organization is made up of individuals dedicated to the

preservation of the compact Buick cars manufactured from 1961 through 1963.  The 

purpose of CBC is to help keep these fine little cars operational by sharing known

resources for parts, technical information, and providing assistance where possible

in restoration projects.  CBC also maintains The Registry at no cost to the contributors. 



Dues are ten dollars annually for U.S. and Canadian members.  For members outside the

U.S. and Canada, dues are fifteen dollars.  Dues are prorated semi-annually for new

members; however, full dues provides all of the year's back issues of a quarterly

Newsletter.  Members also receive a free auto-related advertisement of a maximum 30

words in each issue of the Newsletter, and the opportunity to participate in CBC

activities.

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|      Office Use Only		     |	PLEASE CHECK THE APPLICABLE BOX

|Check / Money Order #:_____________ |	___ Yes, I would like to join CBC now?

|       Date Processed:_____________ |	___ No, I do not want to join at this time.

|      Expiration Date:_____________ |  ___ Please register my car(s)

|               File #:_____________ |      in The Registry at no cost.

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Please print or type the information below. Renewing members provide current address. 

CHECK ONE:  ___NEW   ___RENEW

Name:   __________________________	C.B.C.#:__________________________

Address:__________________________	B.C.A.#:__________________________

City:   __________________________	State:____ Zip:________

Phone:  __________________________	E-mail: __________________________



COMPACT BUICK CARS CURRENTLY OWNED

Ref. Year  Model Number or Type  Body Style (4dr/2dr)  VIN# (On left front door post)

(A)  19__  ____________________  ____________________  ______________________________

(B)  19__  ____________________	 ____________________  ______________________________

(C)  19__  ____________________	 ____________________  ______________________________

(D)  19__  ____________________  ____________________  ______________________________



ADDITIONAL CAR DATA TO BE INCLUDED IN The Registry 

Ref. (A)___  (B)___  (C)___  (D)___(Check as Appropriate)   Year Purchased:__________

Model:_____________  Color Code:__________________________  Trim Code:_______________

                          (Info located on engine firewall data plate)

Year:'61__ '62__ '63__ Compact Buick Series Type: Special__ Special Deluxe__ Skylark__



Engine: HPV8___ V8___ V6___ Other__________  Transmission: 3spd___ 4spd___ Auto___

Original Owner: Yes___ No___

Body: 2Dr___ 4Dr___ 2 Seat Wagon___ 2 Seat Wagon___ Convertible___

Options: Power Steering__ Power Brakes__ Factory Air Conditioner__ 2 Speed Wipers___

Power Convertible Top__ Remote Mirrors__ Power Windows__ Power Seats__ Vinyl Hard Top__

Vehicle usage: Show___ Normal___ Seldom___ Storage___ Work in progress___



Please attach additional pages as needed.

The information for the Compact Buick Club Registry is always appreciated!