Name
Address
City/Town
State	SA VIC NSW ACT QLD NT WA TAS
Postcode
E-mail
Tel
Licence Grade	A B C P
Licence No
Transponder No
Race Number
Race Class 1	N/A Midget Rookie Junior National Light Junior National Heavy Junior National Pro Junior Clubman Junior Max Junior Performance
Race Class 2	N/A Midget Rookie Junior National Light Junior National Heavy Junior National Pro Junior Clubman Junior Max Junior Performance
Race Class 3	N/A Midget Rookie Junior National Light Junior National Heavy Junior National Pro Junior Clubman Junior Max Junior Performance

Payment can be sent to PO Box 1080 Mount Gambier SA 5290 or

Online Payments to BSB 805-023 ACC 02302734

Please include Name, Class Entered & Race Number

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