Membership Application

THE SUBMISSION PROCESS FOR THIS FORM IS NOT CURRENTLY WORKING. Please just mail or email me the relevant Berlina information, including that you can paste this whole form into word processing and print it out. Thanks and sorry for the inconvenience. I'll fix it eventually. Email andrew@berlinaregister.com

If you own an Alfa Romeo 1750 or 2000 Berlina (1967-1976), please join the Berlina Register. The Register is an informal list and clearinghouse of information and documentation on Berlinas, operated by Andrew Watry. I maintain a database of existing Berlinas worldwide, based on completed application forms submitted (see below), and publish a Berlina Register newsletter several times a year. There is no cost to join, but nominal donations and postage stamps are appreciated to keep this shoe-string operation going. For more information, contact Andrew Watry at 1284 Monterey Ave., Berkeley, CA, 94707 USA (510) 526-0391; email: andrew@berlinaregister.com .

Berlina Register Membership Application

Model Year

Bought...

New Used

Miles on car

Engine capacity
Engine no.

Chassis no. (VIN)

Current color
Original color

Current interior color
Original interior color

Induction system

carbureted
fuel injected (inezione)
Other
Other

If carbureted, what type air cleaner?

If USA car, was Spica system removed?

Yes No

Does car have catalytic converter?

Yes No

Transmission

5-Speed Manual Automatic

Differential ratio

4.56 (All US cars)
4.30
4.10


Brake system and pedal type

Floor
Hanging

Single Booster
Dual Booster

Tire brand and size

Wheel size and type

Taillights (amber or red)

Red Amber

Stainless or rubber bumpers

Stainless Rubber

Any factory options on car?





Date purchased

Where purchased (City, State or Country)

Condition of Vehicle

Excellent - Car has been restored (or in suspended animation).
Good - Car has been well maintained and has low mileage and wear.
Acceptable - Car is old and expectantly worn but still straight in good operating condition.
Marginal - Car has problems that need attention, but are not impossible to overcome.
Project - Car is in the midst of a restoration or major overhaul.
Parts - Car exists merely to supply parts to another running Berlina.
Junk - Car is known destroyed, dismantled, or demolished. (Tell us if you know of a destroyed berlina even if it's not yours.)

Has the car been restored?

Yes No

Who did the restoration? (Name any shops or garages which helped and the cities they are located in)







Recommend an Alfa shop?





What modifications have been done?








Has the car been raced or rallied?

Yes No

Cars or parts for sale or wanted








Anything else about the car you'd like to say?

Your other Alfa Romeos





Current owner (you)
Address
Telephone
E-mail address

Any known previous owners





Alfa Romeo club memberships

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Copyright © 1997 by Andrew D. Watry
Questions or Comments? Email Me