ENTRY FORM - NON-JAA MEMBER
2021-2022 SENIOR CATEGORIES
Entrant Name
*
First Name
Last Name
Manufacturer Name
First Name
Last Name
Owner Name
*
* Required for insurance purpose, if different from the Entrant. This can be a person or company
Mobile/Phone
*
Email
*
Company
*
Postal Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of entry
*
Description of entry
*
0/250
Motivation
*
0/250
Materials used
*
0/250
Wholesale value of entry (AUD$)
*
Including materials, labour and GST.
Does the entry contain elements that are cast, CAD/CAM or machine made?
*
Yes
No
Would you be interested in having your entry auctioned (you will have the option to set a minimum reserve and retain the proceeds minus auction commission)?
Yes
No
PAYMENT
*
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Precious Metal (Non-JAA member)
$
205.00
AUD
Colour (Non-JAA Member)
$
205.00
AUD
Diamond (Non-JAA member)
$
205.00
AUD
CAD/CAM/CAST (Non-JAA member)
$
205.00
AUD
Contemporary (Non-JAA member)
$
205.00
AUD
Enter coupon
Apply
Total
$
0.00
AUD
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Declaration
*
*
Submit entry
Should be Empty: