Giulia Super Register Membership Application

Giulia TI / Giulia TI Super / Giulia Super / Giulia 1300 / Giulia Nuova Super 1300 / Giulia Nuova Super 1600 / Giulia Super Promiscua / Giulia Nuova Super Diesel

Model____________________________Year__________License____________Old/New__________

Engine Capacity______________cc Engine#(orig.)____________(current)________________

Chassis#(VIN)___________________

Exterior Color__________________ Original (Y/N)_____

Interior Trim Color_____________ Original (Y/N)_____

Gearbox (Floor/Column)__________ Clutch(cable/hydraulic)________Diff.Ratio_________

Braking System__________________ Original (Y/N)_____

Tire Brand/size_________________ Wheel size_________

Headlights/Foglights(type)________________ Tailights(amber/red)____________________

Date purchased____________________________

Where purchased___________________________

Current state of vehicle___________________________________________________________

___________________________________________________________________________________

What, if any, restoration work has been carried out?_______________________________

___________________________________________________________________________________

Who carried out the restoration work?______________________________________________

Please list any parts available for sale or needed_________________________________

___________________________________________________________________________________

Present Owner_____________________________ Previous Owner(1)_______________________

Address___________________________________ Address_________________________________

City/State/ZIP____________________________ City/State/ZIP__________________________

Telephone_________________________________ Previous Owner(2)_______________________

Email_____________________________________ Address_________________________________

Other club membership#s___________________ City/State/ZIP__________________________

Photos included? (Y/N)____________________

Send to: