Preloved Winnebago Registration Form

Owner

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* 1. Salutation (e.g. Mr / Mrs):

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* 2. First Name:

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* 3. Last Name:

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* 4. Company Name:

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* 5. Date of Birth (dd/mm/yyyy):

Partner

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* 6. Salutation (e.g. Mr / Mrs)

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* 7. First Name:

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* 8. Last Name:

Address

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* 9. Unit / Street Number:

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* 10. Street Address

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* 11. Suburb / Town

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* 12. State:

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* 13. Post Code:

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* 14. Country

Australia

New Zealand

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* 15. Email Address:

Contact Details

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* 16. Phone (Primary Contact):

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* 17. Mobile:

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* 18. Phone Work:

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* 19. Email:

Sale Details

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* 20. Date of purchase:

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* 21. Vehicle Identification Number (VIN):

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* 22. Serial Number (Your serial number is located on the right hand side of the entry door):

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* 23. Registration Number:

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* 24. Registration State (Australia only):

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* 25. Owner Type:

Person

Company

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* 26. Selling Dealer Name or Private Sale:

A&K Winnebago

Albury-Wodonga Winnebago

Australia Motor Homes

Central Winnebago

Country Winnebago

Freedom Winnebago

Geelong Winnebago

Parkland Winnebago

Roberts Winnebago

Motoco Group Cairns

Motoco Group Townsville

Sydney RV Centre Narrabeen

Sydney RV Centre Penrith

Winnebago Adelaide

Other (please specify)

Winnebago RV Club Membership

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* 27. Are you a member of the Winnebago RV Club?

Yes

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* 28. If No would you like more information about the Winnebago RV Club?

Yes