Your Application for Joining CSA Auto Club
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CSA Auto Club Membership
Fields marked with an asterisk (
*
) must be entered.
Member Information
First Name
*
Last Name
*
Street Address
*
City
*
Province
*
Select province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Nova Scotia
N.W. Territories
Nunavut
Ontario
P.E.I.
Quebec
Saskatchewan
Yukon Territories
Postal Code
*
Telephone
*
CSA membership number
*
Email
*
Pricing
Prices include GST
1st Vehicle
$54.00
Additional Vehicles
$33.00
5th Wheel/Double Axle
$75.00
Recreational Vehicles
$87.00
Boat Trailers
$25.00
Note: Recreational Vehicles and 5th Wheel / Double Axle are considered 1st vehicle.
Vehicle Details
Vehicle 1
Type
*
Make
Select Vehicle
1st Vehicle
2nd Vehicle
5th Wheel
RVs
Boat Trailers
Model
Year
Licence number
Province / State
Select Prov / State
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Nova Scotia
N.W. Territories
Nunavut
Ontario
P.E.I.
Quebec
Saskatchewan
Yukon Territories
Alaska
Alabama
Arkansas
American Samoa
Arizona
Barbados
Bahamas
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Guadoloupe
Guam
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Marshall Islands
Michigan
Minnesota
Missouri
Martinique
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Palau
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Virgin Islands
Vermont
Washington
Wisconsin
West Virginia
Wyoming
Vehicle 2
Type
Make
Select Vehicle
1st Vehicle
2nd Vehicle
5th Wheel
RVs
Boat Trailers
Model
Year
Licence number
Province / State
Select Prov / State
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Nova Scotia
N.W. Territories
Nunavut
Ontario
P.E.I.
Quebec
Saskatchewan
Yukon Territories
Alaska
Alabama
Arkansas
American Samoa
Arizona
Barbados
Bahamas
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Guadoloupe
Guam
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Marshall Islands
Michigan
Minnesota
Missouri
Martinique
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Palau
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Virgin Islands
Vermont
Washington
Wisconsin
West Virginia
Wyoming
Vehicle 3
Type
Make
Select Vehicle
1st Vehicle
2nd Vehicle
5th Wheel
RVs
Boat Trailers
Model
Year
Licence number
Province / State
Select Prov / State
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Nova Scotia
N.W. Territories
Nunavut
Ontario
P.E.I.
Quebec
Saskatchewan
Yukon Territories
Alaska
Alabama
Arkansas
American Samoa
Arizona
Barbados
Bahamas
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Guadoloupe
Guam
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Marshall Islands
Michigan
Minnesota
Missouri
Martinique
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Palau
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Virgin Islands
Vermont
Washington
Wisconsin
West Virginia
Wyoming
Total
: