Enrollment Form

BMW Group VIP Request Form
VIP Information
Full Name*

PrefixFirst NameLast Name
Company Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
E-mail*
Vehicle Model*
Website*
If no website, please use N/A.
Occupation

MovieTVSportMusicOther
Renowned

LocalNationalInternational
Major Achievements and additional information about VIP*
How did you receive an invitation into the VIP Program?*
Requestor Information
Please choose*

BMW DealershipBMW Corporate
Dealer Name*
BMW Division*
City*
Contact Name*
Contact Phone*
Contact E-Mail*
Privacy Policy & Legal
Lead Source
Account Type
Type of VIP
# Prefix
Should be Empty: