Inter Club Supersprint Rnd 7 – Entry Form Posted on October 5, 2019October 5, 2019 by sscc01 Step 1 of 4 - Competitor/Entrant Details 25% Competitor / Entrant Name* First Last Entrant Competition Licence Number*Entrant Competition Licence Expiry Date* Date Format: DD slash MM slash YYYY Driver Name* First Last Address* Street Address Address Line 2 Suburb State Post Code Date of Birth* Date Format: DD slash MM slash YYYY Email* Phone (Mobile)*Phone (Alternate)Club*Southern Sporting Car ClubWRX Club of NSWRoad & Track Drivers ClubMembership Number*Expiry Date* Date Format: DD slash MM slash YYYY Emergency Contact - Name*Emergency Contact - Phone* Is this your First Supersprint*YesNoIs this your first event at Marulan?*YesNoCompetition Number (1st Preference)*Competition Number (2nd Preference)* My first preference is my Interclub Registered number Make*Model*Year*20182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930Colour*Capacity (CC)*Please enter CCs, ie 1600, 2000. Please do not use 1.6 or 5.7Turbo / Supercharged*NoYesIs the Vehicle double entered*NoYesDual Entered Drivers NameDual Entered competition numberVehicle Type*Type 1 - Unmodified Production CarsType 2 - Modified Production CarsType 3 - Competition Vehicles based on 3J (IPRA)Type 4 - Competition Vehicles based on 2F (Prod Sports)Type 5 - Competition Vehicles based on 3D (Sports Sedans)Type 6 - Highly modified mass produced Vehicles (aka Time Attack)Type 7 - Clubmans, Kit Cars and ReplicasVehicle Class (Type 1)*A - 0 - 1600ccB - 1601 - 2000ccC - 2001 - 4000ccD - 4001cc & aboveVehicle Class (Type 2)*A - 0 - 1600ccB - 1601 - 2000ccC - 2001 - 4000ccD - 4001cc & aboveVehicle Class (Type 3)*A - 0 - 1600ccB - 1601 - 2000ccC - 2001 - 4000ccD - 4001cc & aboveVehicle Class (Type 4)*A - 0 - 1600ccB - 1601 - 2000ccC - 2001 - 4000ccD - 4001cc & aboveVehicle Class (Type 5)*A - 3D Sports Sedan (engine up to 4000cc)B - 3D Sports Sedan (engine from 4001cc to 6000cc)C - 2B Prod Sports (engine up to 4000cc)D - 2B Prod Sports (engine from 4001cc to 6000cc)Vehicle Class (Type 6)*A - Naturally aspiratedB - Forced InductionC - Two Wheel drive (open category)D - Four Wheel drive (open category)Vehicle Class (Type 7)*A - Road registered ClubmansB - Non Road Registered ClubmansC - Racing Cars, Sports Racing Cars, Sports Racers (up to 2000cc)D - Racing Cars, Sports Racing Cars, Sports Racers (greater than 2000cc)Do you have an estimate lap time for Pheasant Wood?*YesNoEstimated Lap timePlease provide lap time in seconds. ie, 1:05 would be 65. Do you have any lap times for the following tracks Wakefield Park SMP Druitt (North) SMP Gardiner (GP) SMP Brabham (Full) Wakefield Park Lap timePlease provide lap time in seconds. ie, 1:05 would be 65. SMP North Lap timePlease provide lap time in seconds. ie, 1:05 would be 65. SMP GP Lap timePlease provide lap time in seconds. ie, 2:15 would be 135. SMP Brabham Lap timePlease provide lap time in seconds. ie, 2:15 would be 135. Payment Type*Direct DepositSecure Credit Card (online) + 1.5%PayPal + 2.5%Entry Fee Price: $ 185.00 Credit Card Fee Price: $ 0.00 PayPal Fee Price: $ 0.00 Total $ 0.00 Credit Card* MasterCardVisa Card Number Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Expiration Date Security Code Cardholder Name Posted in Events.
