Membership Application

Do you Accept the Terms and Conditions?
YesNo

First Name (required)

Last Name (required)

South African ID Number (required)

At the date of making this application are you younger than 18 years of age
YesNo

If you answered yes to being under 18 years of age please provide the contact details for your parent or legal guardian

Contact e-mail address (required)

Contact Number (required)

Alternate contact number (required)

Domicile city or town (required)

What type of membership are you applying for?
---Full Local, 1st Family Member R825Full Local, 2nd Family Member R500Full Local, Every Additional Member R400Country Membership, 1st Family member R500 (persons residing more than 200km from Aldo Scribante)Country Membership, Every Additional Family Member R450 (persons residing more than 200km from Aldo Scribante)New Member 1st Year R540Drag Racing R300Spinning R300Enduro/Off Road Motorcycles R300Rally/Offroad Cars R300Social R300Officials/Honory R0

Name and Surname of Main Member

What class of circuit racing do you plan to primarily take part in? (required)
---Circuit – Sports & GT CarsMSA National Status EventsModified Saloon CarsHistorics and Classic CarsMotorcyclesMarque and Street CarsNon Circuit RacingOfficialSpinningDragsEnduroRally

How are you going to pay your fees? (required)
---EFTCardOfficials

Payment Date (required) e.g.2018/01/08