MBCSA Application form 2025

MBCSA Application form 2025

Membership Application Form 2026

New Member Details:
Initials & Surname
Name
ID Number
Occupation
Membership Number
For re-applications only.
Residential address

CityProvince

Postal Code
Cell Number
Format: (000) 000-0000.
E-mail
Spouse

Children: Name & DOB

Rows	Name	Date of Birth
#1
#2
#3
#4
#5

Vehicles:

Rows	Year	Colour	Model	Series	Vin
#1
#2
#3
#4
#5

Membership Fees:
Initial Registration Fees
prevnext( X )
1st Quarter: January - December 20251,100.00 ZAR

2nd Quarter: April - December 20251,000.00 ZAR

3rd Quarter: July - December 2025800.00 ZAR

4th Quarter: October - December 2025600.00 ZAR

Re-application755.00 ZAR

Optional: Nametag for family members150.00 ZAR

Quantity

Optional: Indemnity cards for family members25.00 ZAR

Quantity

Gift Pack : 1 x Grill badge; 1 x Key ring; 1 x Lapel pin 1,000.00 ZAR

Total 0.00 ZAR
Declaration
Banking Details:

STANDARD BANK

ACCOUNT NO: 020939442

BANK CODE: 01-20-42

Email proof of bank deposit to membership@mercedesbenzclub.co.za

New membership applications will be processed on Wednesday mornings between 09h00 - 12h00!
Special Requests:
Should be Empty: