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Preloved Winnebago Registration Form
Owner
1.
Salutation (e.g. Mr / Mrs):
*
2.
First Name:
(Required.)
*
3.
Last Name:
(Required.)
4.
Company Name:
*
5.
Date of Birth (dd/mm/yyyy):
(Required.)
Partner
6.
Salutation (e.g. Mr / Mrs)
7.
First Name:
8.
Last Name:
Address
9.
Unit / Street Number:
*
10.
Street Address
(Required.)
*
11.
Suburb / Town
(Required.)
12.
State:
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
*
13.
Post Code:
(Required.)
*
14.
Country
(Required.)
Australia
New Zealand
15.
Email Address:
Contact Details
16.
Phone (Primary Contact):
17.
Mobile:
18.
Phone Work:
19.
Email:
Sale Details
*
20.
Date of purchase:
(Required.)
21.
Vehicle Identification Number (VIN):
*
22.
Serial Number (Your serial number is located on the right hand side of the entry door):
(Required.)
23.
Registration Number:
24.
Registration State (Australia only):
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
25.
Owner Type:
Person
Company
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
27.
Are you a member of the Winnebago RV Club?
Yes
No
28.
If No would you like more information about the Winnebago RV Club?
Yes
No
