ANSMA Club Membership Individual (Renewal 2)

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Get Page URL
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Enter your ANSMA email address* This field is required.Please use all lowercase
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Email Address* This field is required.
example@example.com
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Member Number* This field is required.
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Member First Name* This field is required.
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Member Last Name* This field is required.
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Is this vehicle a 4WD or recreational (caravan, motorhome, RV) vehicle* This field is required.
YESNO
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Is your vehicle 30 years or older as from year of manufacture ?* This field is required.
YESNO
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Has this vehicle been registered before?* This field is required.
YESNO
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Current Registration Number * This field is required.
If not registered type N/A
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Model Make* This field is required.eg, Ford or Toyota
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Model* This field is required.Cortina or MR2
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Model Shape* This field is required.eg Coupe, Sedan, Ute etc
ie Coupe, Sedan, Ute, etc
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Model Year of Manufacture* This field is required.
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VIN Number* This field is required.VIN or Chassis/frame or serial number
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Engine Number* This field is required.
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Rim Size* This field is required.
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Has your vehicle had modifications * This field is required.
YESNO
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List all modifications in detail* This field is required.
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Upload engineering certificate/s include date of issue for work on any modifications
Drag and drop files here
Select files to upload
Max. file size: 4.9MB
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Upload an engine photo* This field is required.Please upload a close up of your engine
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Select files to upload
Max. file size: 4.9MB
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Upload a side view photo* This field is required.
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Select files to upload
Max. file size: 4.9MB
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Upload a front view photo* This field is required.
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Max. file size: 4.9MB
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Upload a rear view photo* This field is required.
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Max. file size: 4.9MB
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Upload an interior photo* This field is required.Preferably taken from behind the steering wheel facing towards rear
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Select files to upload
Max. file size: 4.9MB
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Leave blank unless you have been asked for an extra photo Please only use this upload if you have been asked for an extra photo after submission
Drag and drop files here
Select files to upload
Max. file size: 4.9MB
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Thanks...hit submit
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