Nomination Form

Nomination Form
Event
Nominations Close

Day Month Year
AM/PM Option
Sorry Nominations Have Closed For This Event
Date Time Now

Day Month Year
Date Hour Minutes AM/PM Option
Date Time Calculation
Contact Person *

First Name Last Name
Email *
example@example.com
Phone Number *
Payment
Refund

Refunded
Payment Method *
Pay Online Discount
Discount per Class
Total Cost
Online Payment

prev next ( X )
AUD Nomination Payment
Pay Online and save ${payOnline} per class.

That is a total saving of {payOnline279} for your nomination.
Standard Total
Online Total
Pay Online Saving
How Many Drivers *
How many drivers are you nominating?

Driver 1
Name 1 *

First Name Last Name
Club 1 *
Drivers Home Club
AIDKA Licence 1 *
Enter 0 (zero) for Single Event Licence
Classes 1 *
How many classes is this driver entering?
Class 11 *
Driver 1 Class 1
Kart 11 *
Kart Number
Entry 11 *
Entry Type
Transponder 11
Number, Hire or n/a for Midget and Rookie
Class 11 Cost
Class 11 Online Cost
Class 12 *
Driver 1 Class 2
Kart 12 *
Kart Number
Entry 12 *
Entry Type
Transponder 12
Number or Hire
Class 12 Cost
Class 12 Online Cost
Class 13 *
Driver 1 Class 3
Kart 13 *
Kart Number
Entry 13 *
Entry Type
Transponder 13
Number or Hire
Class 13 Cost
Class 13 Online Cost
Class 14 *
Driver 1 Class 4
Kart 14 *
Kart Number
Entry 14 *
Entry Type
Transponder 14
Number or Hire
Class 14 Cost
Class 14 Online Cost

Driver 2
Name 2 *

First Name Last Name
Club 2 *
Drivers Home Club
AIDKA Licence 2 *
Enter 0 (zero) for Single Event Licence
Classes 2 *
How many classes is this driver entering?
Class 21 *
Driver 2 Class 1
Kart 21 *
Kart Number
Entry 21 *
Entry Type
Transponder 21
Number, Hire or n/a for Midget and Rookie
Class 21 Cost
Class 21 Online Cost
Class 22 *
Driver 2 Class 2
Kart 22 *
Kart Number
Entry 22 *
Entry Type
Transponder 22
Number or Hire
Class 22 Cost
Class 22 Online Cost
Class 23 *
Driver 2 Class 3
Kart 23 *
Kart Number
Entry 23 *
Entry Type
Transponder 23
Number or Hire
Class 23 Cost
Class 23 Online Cost
Class 24 *
Driver 2 Class 4
Kart 24 *
Kart Number
Entry 24 *
Entry Type
Transponder 24
Number or Hire
Class 24 Cost
Class 24 Online Cost

Driver 3
Name 3 *

First Name Last Name
Club 3 *
Drivers Home Club
AIDKA Licence 3 *
Enter 0 (zero) for Single Event Licence
Classes 3 *
How many classes is this driver entering?
Class 31 *
Driver 3 Class 1
Kart 31 *
Kart Number
Entry 31 *
Entry Type
Transponder 31
Number, Hire or n/a for Midget and Rookie
Class 31 Cost
Class 31 Online Cost
Class 32 *
Driver 3 Class 2
Kart 32 *
Kart Number
Entry 32 *
Entry Type
Transponder 32
Number or Hire
Class 32 Cost
Class 32 Online Cost
Class 33 *
Driver 3 Class 3
Kart 33 *
Kart Number
Entry 33 *
Entry Type
Transponder 33
Number or Hire
Class 33 Cost
Class 33 Online Cost
Class 34 *
Driver 3 Class 4
Kart 34 *
Kart Number
Entry 34 *
Entry Type
Transponder 34
Number or Hire
Class 34 Cost
Class 34 Online Cost

Driver 4
Name 4 *

First Name Last Name
Club 4 *
Drivers Home Club
AIDKA Licence 4 *
Enter 0 (zero) for Single Event Licence
Classes 4 *
How many classes is this driver entering?
Class 41 *
Driver 4 Class 1
Kart 41 *
Kart Number
Entry 41 *
Entry Type
Transponder 41
Number, Hire or n/a for Midget and Rookie
Class 41 Cost
Class 41 Online Cost
Class 42 *
Driver 4 Class 2
Kart 42 *
Kart Number
Entry 42 *
Entry Type
Transponder 42
Number or Hire
Class 42 Cost
Class 42 Online Cost
Class 43 *
Driver 4 Class 3
Kart 43 *
Kart Number
Entry 43 *
Entry Type
Transponder 43
Number or Hire
Class 43 Cost
Class 43 Online Cost
Class 44 *
Driver 4 Class 4
Kart 44 *
Kart Number
Entry 44 *
Entry Type
Transponder 44
Number or Hire
Class 44 Cost
Class 44 Online Cost

Driver 5
Name 5 *

First Name Last Name
Club 5 *
Drivers Home Club
AIDKA Licence 5 *
Enter 0 (zero) for Single Event Licence
Classes 5 *
How many classes is this driver entering?
Class 51 *
Driver 5 Class 1
Kart 51 *
Kart Number
Entry 51 *
Entry Type
Transponder 51
Number, Hire or n/a for Midget and Rookie
Class 51 Cost
Class 51 Online Cost
Class 52 *
Driver 5 Class 2
Kart 52 *
Kart Number
Entry 52 *
Entry Type
Transponder 52
Number or Hire
Class 52 Cost
Class 52 Online Cost
Class 53 *
Driver 5 Class 3
Kart 53 *
Kart Number
Entry 53 *
Entry Type
Transponder 53
Number or Hire
Class 53 Cost
Class 53 Online Cost
Class 54 *
Driver 5 Class 4
Kart 54 *
Kart Number
Entry 54 *
Entry Type
Transponder 54
Number or Hire
Class 54 Cost
Class 54 Online Cost

Submit
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