Join Now

 
 
 

SURNAME TITLE GIVEN INITIAL

POSTAL ADDRESS

NUMBER STREET NAME

SUBURB / TOWN STATE POSTCODE

HOME ADDRESS

NUMBER STREET NAME

SUBURB / TOWN STATE POSTCODE

HOME PHONE MOBILE PHONE WORK PHONE

EMAIL ADDRESS


VEHICLE REG YEAR (MUST BE LESS THAN 20 YEARS)

MAKE MODEL

BODY TYPE COLOUR

FUEL TYPE TRANSMISSION CYLINDERS

VIN NUMBER ENGINE NUMBER


MEMBERSHIP TYPE


PAYMENT DETAILS

CREDIT CARD TYPE CARD NUMBER EXPIRY MMYY

CARDHOLDER NAME

DRIVERS LICENSE NUMBER


EXISTING ROADSIDE COVER

EXPIRY DATE MONTH YEAR

MOTORING 24-7 COVER WILL COMMENCE FROM THIS TIME

BONUS - YOU WILL GET THE EXPIRY & FOLLOWING MONTH FREE!

UP TO 14 MONTHS FOR THE PRICE OF 12 !!!

(Not to be used in conjunction with any other offer.)


SPONSOR NAME (OPTIONAL)


SEND ME INFORMATION FROM M24-7 OR PARTNERS

OOPS, WANT TO START AGAIN!

ALL OK

 

   
 
Updated 07.10.08
  To contact us:    
 

Smartmotoringassociation Pty Ltd.
PO BOX 10123
ADELAIDE 5000
SOUTH AUSTRALIA

 

Phone: 1300 303 917
Fax: 08 8377 7147
E-mail: admin@smartmotoring.com.au