SoCal C63 AMGs Membership Form
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First Name *
Last Name *
Email Address *
This field will be hidden to other members. Your email address might be used for group-related communication as part of a BCC list. No spam, no unsolicited emails. Your address will never be shared with third parties.
Member of the Facebook group "SoCal C63 AMGs"? *
Member of the Facebook group "AMG SoCal Lounge"? *
Interested in *
Required
Nickname
MB World Nickname
Your nickname on http://mbworld.org/, if you have an account.
AMG Private Lounge Nickname
Your nickname on http://www.mercedes-amg.com/privatelounge/, if you have an account.
Year of your C63 *
Trim of your C63 *
Body style of your C63 *
Color of your C63 *
Photo of your car
Please enter an URL which points to a photo of your car.
Tell us more about car
City *
Gender
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Date of Birth
This field will be hidden to other members. It will be used for wishing you a happy birthday and for displaying anonymized statistics. Please fill out at least the correct year.
MM
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DD
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YYYY
Tell us more about yourself
Company
Position
Website
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