revised Feb 24 2022
MEMBERSHIP APPLICATION
You can fill out the application and mail to the address at the right
or you can email the application
to Bob Merritt bob@simplexco.com
or Gloria Moon agmoon300@gmail.com
CHRYSLER 300 CLUB INTERNATIONAL, INC.
PO Box 40
Benson, MD 21018



  • NAME:   _______________________________________________


  • SPOUSE:  _____________________________________________


  • ADDRESS: ____________________________________________


                               ____________________________________________


                              _____________________________________________


  • PHONE: (____) ____________________         CELL PHONE: (____) ____________________
  • FAX: (____) ____________________

  • EMAIL ADDRESS: _____________________________________

  • YES____ NO_____ : I am interested in joining the Club's free on-line discussion group - listserver.

    PLEASE LIST ALL CHRYSLER 300 AUTOMOBILES CURRENTLY OWNED
    Vehicle Serial Number (VIN) Year Ht / Cvt Color List of Options








































    MEMBERSHIP DUES: US and Canada $35.00 per year. Foreign $40.00 per year.
    Payable 1, 2 or 3 years in advance.
    We can accept dues via Paypal. For information, click here.

    Please, U.S. Funds or International Bank Draft only. Add $20.00 to dues to cover PNC bank charge on International wire transfers .