SA Supra Club Membership

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Please complete the following details to sign up to the SA Supra club.

Please note your membership is not valid until payment has been received.

Email *

First Name *

Last Name *

Mobile Number *

Postal Address *

Vehicle Make *

Vehicle Model *

Vehicle Year *

Vehicle Registration Number (If it has one)

Disclaimer *

I agree to abide by the rules and regulations of the Supra Club

Yes

Required

What type of events would you like to see the club run?

Preferred Method of Contact *

SMS

E-mail

Physical Membership Card *

Not required

Collect at next event

Please send to my postal address specified above

Payment Details

Please confirm you have paid the applicable fee's of:

Yearly Membership Fee: $30

To the SA Supra bank account.
Payment Details:
Bank SA
BSB: 105 081
Account: 069679140
Account Name: South Australian Supra Club
Payment Reference: YourName Membership

Alternatively Payment can be made via PayPal through our online store:
https://store.sasupra.com.au/product/club-membership

Payment *

I have paid via the SA Supra Store (Paypal)

I have paid via Bank Deposit

A copy of your responses will be emailed to the address you provided.

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