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Membership Level
Choose Gift Recipient Membership Level
*
One Year
$49
Two Year
$88
Three Year
$123
Lifetime
$750
Gift Recipient Information
First Name
*
Middle Initial
Last Name
*
Company
Address
*
Address (Optional)
City
*
State/Province
*
Zip/Postal Code
*
Country
*
United States
Home Phone
Work Phone
Cell Phone
Email *
How did Gift Recipient hear about the club?
*
- Select a value -
Friend/Relative
Audi Dealership
Internet/web
iPhone/Android App
Driving Schools/Club Events
Audi Mailing
Independent Auto Repair
quattro quarterly magazine
Audi Magazine/Other publications
Forums (Audiworld/Fourtitude/etc)
Friend or relative's name
Gift Recipient Additional Family Information
First Name
Middle Name
Last Name
Email
Gift Recipient Vehicle Information
Year
Audi Model
- None -
100
100 Avant
200
200 Avant
4000
5000
80
90
90 Cabriolet
A2
A3
A3 TDI
A4
A4 Avant
A4 Cabriolet
A5
A5 Cabriolet
A5 Sportback
A6
A6 Avant
A7
A8
Allroad
Cabriolet
Coupe GT
Coupe Quattro
e-tron
Fox
NSU 1200 TT
Q3
Q5
Q5 TDI
Q7
Q7 TDI
Q8
R8
R8 Spyder
RS2
RS3
RS4
RS4 Avant
RS4 Cabriolet
RS5
RS6
RS7
S1 Group B
S2
S3
S4
S4 Avant
S4 Cabriolet
S4 Prestige
S5
S5 Cabriolet
S5 Sportback
S6
S6 Avant
S7
S8
Sport Quattro
Sport TT Cup
SQ5
TT Coupe
TT Roadster
TT RS Coupe
TT RS Roadster
TTS Coupe
TTS Roadster
UR Quattro
V8 Quattro
Year
Audi Model
- None -
100
100 Avant
200
200 Avant
4000
5000
80
90
90 Cabriolet
A2
A3
A3 TDI
A4
A4 Avant
A4 Cabriolet
A5
A5 Cabriolet
A5 Sportback
A6
A6 Avant
A7
A8
Allroad
Cabriolet
Coupe GT
Coupe Quattro
e-tron
Fox
NSU 1200 TT
Q3
Q5
Q5 TDI
Q7
Q7 TDI
Q8
R8
R8 Spyder
RS2
RS3
RS4
RS4 Avant
RS4 Cabriolet
RS5
RS6
RS7
S1 Group B
S2
S3
S4
S4 Avant
S4 Cabriolet
S4 Prestige
S5
S5 Cabriolet
S5 Sportback
S6
S6 Avant
S7
S8
Sport Quattro
Sport TT Cup
SQ5
TT Coupe
TT Roadster
TT RS Coupe
TT RS Roadster
TTS Coupe
TTS Roadster
UR Quattro
V8 Quattro
Year
Audi Model
- None -
100
100 Avant
200
200 Avant
4000
5000
80
90
90 Cabriolet
A2
A3
A3 TDI
A4
A4 Avant
A4 Cabriolet
A5
A5 Cabriolet
A5 Sportback
A6
A6 Avant
A7
A8
Allroad
Cabriolet
Coupe GT
Coupe Quattro
e-tron
Fox
NSU 1200 TT
Q3
Q5
Q5 TDI
Q7
Q7 TDI
Q8
R8
R8 Spyder
RS2
RS3
RS4
RS4 Avant
RS4 Cabriolet
RS5
RS6
RS7
S1 Group B
S2
S3
S4
S4 Avant
S4 Cabriolet
S4 Prestige
S5
S5 Cabriolet
S5 Sportback
S6
S6 Avant
S7
S8
Sport Quattro
Sport TT Cup
SQ5
TT Coupe
TT Roadster
TT RS Coupe
TT RS Roadster
TTS Coupe
TTS Roadster
UR Quattro
V8 Quattro
Year
Non-Audi Model
Year
Non-Audi Model
Gift Recipient Dealer Information
Who is Gift Recipient Audi dealer?
City
State/Province
Did an Audi Dealership Employee refer you to the Audi Club?
*
No
Yes
Name
Position at the dealership
Gift Membership From
Your First Name
*
Your Last Name
*
Your Address
*
Your City
*
Your State/Province
*
Your Zip/Postal Code
*
Your Country
*
- Select a value -
Argentina
Australia
Austria
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Brazil
Brunei Darussalam
Bulgaria
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Chad
Chile
China
Colombia
Costa Rica
Croatia
Cuba
Czech Republic
Denmark
Ecuador
Egypt
El Salvador
Finland
France
Germany
Greece
Greenland
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic of
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kenya
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Lao People's Democratic Republic
Lebanon
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia, The Former Yugoslav Republic of
Madagascar
Malaysia
Maldives
Malta
Mexico
Monaco
Mongolia
Montenegro
Morocco
Netherlands
New Caledonia
New Zealand
Nicaragua
Norway
Oman
Pakistan
Palestine, State of
Panama
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Saudi Arabia
Senegal
Serbia
Singapore
South Africa
Spain
Sri Lanka
Sudan
Suriname
Sweden
Switzerland
Taiwan, Province of China
Thailand
Turkey
Turkmenistan
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Venezuela, Bolivarian Republic of
Viet Nam
Yemen
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