Motor Club Sign up page, Use our fast and secure form to get started!

Motor Club Sign Up

Please us the secure motor club sign up form below. You're on your way to enjoying safety and security on the road. Please fill out this form to begin:

GM Motor Club Sign Up
Please note that all fields followed by an asterisk must be filled in.
First Name* First Name*
Last Name* Last Name*
E-mail Address* E-mail Address*
Street Address* Street Address*
City* City*
State/Prov* State/Prov*
Zip/Postal Code* Zip/Postal Code*
Home Phone* Home Phone*
Business Phone
Do you Currently have a GMAC auto policy?* Do you Currently have a GMAC auto policy?*
If yes, policy number.
Card Type* Card Type*
Cardholder Name* Cardholder Name*
Card Number* Card Number*
Expiration Date (MM/YYYY)* Expiration Date (MM/YYYY)*
Card Security Code. (3 digit number on back right of card)* Card Security Code. (3 digit number on back right of card)*
Auto-renewal.* Auto-renewal.*
Would you like to add your spouse or dependent child for only $15 each?* Would you like to add your spouse or dependent child for only $15 each?*
1st Associate Member's Full Name
1st Associate Member's Date of Birth(mmddyy)
Relation
2nd Associate Member's Full Name
2nd Associate Member's Date of Birth(mmddyy)
Relation
Please enter the word that you see below.

Please Note: By entering my credit card information above, I authorize GM Motor Club to charge my credit card for my first year's membership fees in the amount $69.00 and $15 for each associate member. Associate members can be a spouse or a dependent child less than 21 years old living in your household.

*Auto-Renewal information: By checking yes in the auto-renew box I authorize the credit card above to be billed in future years for renewal membership fees. I understand I can stop using this feature at any time by contacting the customer service center.

Membership Effective Date Your membership will be effective one day after payment is processed.

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