SSC Membership Registration Form

SSC Membership Registration

Complete the form below and we will get in contact with you to confirm details and organise the collection of your 24/7 key tag.
Name

First NameLast Name
E-mail
Phone Number
Please enter a valid phone number.Format: 0000 000 000.
Address

Street Address

Street Address Line 2

SuburbState

Postal CodeCountry
Birth Date

DayMonthYear
Preferred way to contact
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: 0000 000 000.
Membership Agreement
Signature
Membership Options
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Basic Direct Debit $20/Week (Set Up and Key Tag Fee Payable Today)
(Fortnightly direct debit payments will be organised upon collection of key tag)

$50.00 AUD



Basic 1 Month Membership
$150.00 AUD



Basic 3 Month Membership
$300.00 AUD



Basic 6 Month Membership
$450.00 AUD



Basic 12 Month Membership
$700.00 AUD



Performance Direct Debit $35/Week (Set Up and Key Tag Fee Payable Today)
(Fortnightly direct debit payments will be organised upon collection of key tag)

$50.00 AUD



Performance 1 Month Membership
$180.00 AUD



Performance 3 Month Membership
$440.00 AUD



Performance 6 Month Membership
$720.00 AUD



Performance 12 Month Membership
$1,280.00 AUD



Total

$0.00 AUD
For Weekly Direct Debit, please input your BSB and Acc. No:

BSB:ACCOUNT NUMBER:

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

SSC Membership Registration