Membership/Renewal Application
Riviera Owners Association, P.O. Box 261218, Denver, CO 80226-9218
phone: 303-233-2987 • fax: 303-984-0909, • email: • website:
A non-profit membership corporation dedicated to the 1963-1999 Riviera by Buick

New Member Renewal: ROA # Prior ROA Member # (if known)
Name: Spouse:
City: State: Zip:
Country: Phone: Email:
Referred by: ROA # (if known):
Rivieras Currently Owned (ownership is not required)
Year Model (GS, etc.) Mileage Color (in & out) Original Restored Under Restoration Modified Custom

Benefits of Membership
• Membership card, decal and club cards
• Six bimonthly issues of the Riview, our 36-page color magazine with
   Technical Tips, Members Showcases Classifieds and more.
• Free 45-word advertisement per member, per issue.
• Access to the “Members Only” section of our website.
• Access to past issues of the Riview, posted on our website.
• Access to technical advice, and our extensive library.
• Participation in international and local events.
• International Air Mail included.

U.S.:   1 year = $30.00
2 years = $55.00
3 years = $80.00
Foreign:   1 year =  $40.00
2 years = $75.00
3 years = $110.00
Methods of Payment
1. Online payments are accepted by credit card or PayPal on our website at
2. Checks and Money Orders made out to "Riviera Owners Association" or "ROA." Applicants outside the USA must use checks drawn on a US bank and made payable in US dollars.
3. To pay by credit card offline, complete all information in this form, click the PRINT button to print a copy of the form and mail it to the address listed at the bottom of the page.
We accept:Credit Cards Accepted:  Visa, Mastercard, AMEX, Discover, Paypal
Amount enclosed $
Acct. # - - - Exp. Date (MM/YY)
Print Name on Card: Signature:
Mail to ROA, P.O. Box 261218, Denver, CO 80226-9218

Notice: BUICK and RIVIERA are trademarks of GENERAL MOTORS CORPORATION used with permission. The Riviera Owners Association is independent and not affiliated with GENERAL MOTORS CORPORATION or its BUICK MOTORS DIVISION    —Copyright 2007 Riviera Owners Association—