Junior Member Subscription

Please enter information on the form below to process subscription for Junior Member.

Email *

Password*

Retype Password *

First Name *

Last Name *

Date of Birth *

Please enter date as Day-Month-Year e.g 01-01-1900

Address *

Address2

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Postcode *

Country *

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Home Phone

Mobile Phone *

Comment

Occupation *

Have you completed a NSW Working With Children Check? *

Check Number

Do you hold a Motorsport Australia Licence (Official or Competition)? *

Please Provide Your Motorsport Australia Licence Number (Official or Competition)

How did you hear about NSSCC? *

Coupon

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Expiration Date*

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Card Holder Name*

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