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 R865Full Local, 2nd Family Member R525Full Local, Every Additional Member R425Country Membership, 1st Family member R525 (persons residing more than 200km from Aldo Scribante)Country Membership, Every Additional Family Member R425 (persons residing more than 200km from Aldo Scribante)New Member 1st Year R500Drag Racing R275Spinning R275Enduro/Off Road Motorcycles R275Rally/Offroad Cars R275Social R275Officials R0Honorary Member R0Honorary Life Member 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 CarsCoastal ChallengeMotorcyclesMarque and Street CarsNon Circuit RacingOfficialSpinningDragsEnduroRally

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

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