Booking Request

Use this form to request enrolment in:

• DRIFT SCHOOL - COST: $200

After FULL PAYMENT is received, your request will be processed and confirmation with further details will be forwarded to you. As course numbers are limited and conditions apply, acceptance of your request is not automatic. You must receive our confirmation before the booking is firm.

Available Dates: see the Coarse Dates field below.

		NB: ALL fields must be completed
Course Dates		Choose Tuesday 23rd Feb Drift night 5pm-9pm Tuesday 23rd Mar Drift night 5pm-9pm Saturday 24th April 2010, 9am - 1pm Saturday 24th April 2010, 1pm - 5pm Wednesday 2nd June Drift night 5pm-9pm Monday 14th June 2010, 9am - 1pm Monday 14th June 2010, 1pm - 5pm Wednesday 14th July Drift night 5pm-9pm Monday 2nd August 2010, 9am - 1pm Monday 2nd August 2010, 1pm - 5pm Wednesday 22th Sep drift night 5pm-9pm Monday 4th October 2010, 9am - 1pm Monday 4th October 2010, 1pm - 5pm Wednesday 8th Dec drift night 5pm-9pm    Licence Choose Full
Your Name
Address
Suburb		Postcode
Phone
Mobile
Email
Gift to		(optional name to appear on Gift Certificate if required)
Vehicle		(make and model of your vehicle that you will be using)
Payment by		Credit Card  OR  Direct Deposit
Pay by Card		If paying by Mastercard OR VISA Card complete below. If Direct Deposit preferred, follow details further below.
Card Holder
Card Number		Expiry
		NOTE: All Credit Card Transactions will incur a 3.0% Surcharge, all prices displayed are in Australian Dollars (AUD) and include GST

Pay by Direct Deposit
Be sure to include a reference in the form stipulated here so that we can identify your payment.

Reference		(your surname)-DRIFT
Bank		Commonwealth
Account		Australian Racing Drivers Club
BSB		062-004
Account#		10086042

Copyright ^© 1999-2009 Australian Racing Drivers Club Limited. Ph: +61 2 9672-1000