2022 Desert Nationals Alice Springs Inland Dragway Nomination Form

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𝟐𝟎𝟐𝟐 𝐃𝐞𝐬𝐞𝐫𝐭 𝐍𝐚𝐭𝐢𝐨𝐧𝐚𝐥𝐬
𝐒𝐚𝐭𝐮𝐫𝐝𝐚𝐲 𝟐𝟑𝐫𝐝 𝐉𝐮𝐥𝐲 𝟐𝟎𝟐𝟐 𝐚𝐧𝐝 𝐒𝐮𝐧𝐝𝐚𝐲 𝟐𝟒𝐭𝐡 𝐉𝐮𝐥𝐲 𝟐𝟎𝟐𝟐

𝐄𝐧𝐭𝐫𝐲 𝐅𝐞𝐞𝐬
𝐄𝐀𝐑𝐋𝐘 𝐁𝐈𝐑𝐃: $𝟐𝟓𝟎 𝐄𝐍𝐃𝐒 𝟑𝟏 𝐌𝐚𝐲 𝟐𝟎𝟐𝟐

𝐄𝐧𝐭𝐫𝐲 𝟏𝐬𝐭 𝐉𝐮𝐧𝐞 𝟐𝟎𝟐𝟐 - 𝟏𝟐𝐭𝐡 𝐉𝐮𝐥𝐲 𝟐𝟎𝟐𝟐
Sportsman Classes $280
Junior Dragster $80
Non Competition $85

$𝟑𝟎𝟎 𝐋𝐚𝐭𝐞 𝐄𝐧𝐭𝐫𝐲 𝟏𝟑𝐭𝐡 𝐉𝐮𝐥𝐲 𝟐𝟎𝟐𝟐 -𝟏𝟗𝐭𝐡 𝐉𝐮𝐥𝐲 𝟐𝟎𝟐𝟐

Account Name: Central Australian Drag Racing Association
BSB: 633000
A/C Number: 145214359

For reference please place Surname and ANDRA Licence Number please.

Thank you.

* For any queries or questions please email secretary.cadra@outlook.com or call Heather on 0418 180 286 or Dan 0400 665 123

Email *

Brackets and Entry Fees (see above for Early Bird and Late Entry prices) *

S/G (Super Gas) $280

JD (Junior Dragster) $80

SS/T (Super Street) $280

MB (Modified Bike) $280

SE (Super Sedan) $280

MO (Modified) $280

TS (Top Sportsman) $280

SCO (Supercharged Outlaws) $280

CB (Competition Bike) $280

SS (Super Stock) $280

CO (Competition) $280

NON COMPETITION CAR (Street Car) $85

NON COMPETITION BIKE (Street Bike) $85

Other:

Required

ANDRA Licence Number (Number given by ANDRA) *

I have completed the ANDRA acknowledgement of risk https://www.andra.com.au/risk-statement/ *

Yes

Required

First Name *

Last Name *

Date of Birth *

YYYY

Street Address *

Suburb, State and Postcode *

Phone *

Email *

Drivers Licence Number, State and Expiry - Street Car Category Only

Vehicle Year *

Vehicle Make *

Vehicle Model / Body Style *

Vehicle Colour *

Engine Make, Type (I-4, I-6, V8, rotary etc) & Cubic Capacity *

Sponsors and Announcer Info

1/4 Mile ET

Please name crew attending. Crew numbers as per ANDRA rulebook, Group 3&4, 3 Crew, (Plus Driver) TS, SCO & Group 2, 5 Crew (Plus Driver). *

Pit Requests: Exactly how much room you need not want. Who you would like to pit next to or near. WE WILL DO OUR BEST TO FULLFIL THESE REQUEST BUT ISN'T ALWAYS POSSIBLE.

𝐒𝐜𝐫𝐮𝐭𝐢𝐧𝐞𝐞𝐫𝐢𝐧𝐠:
𝐀𝐍𝐃𝐑𝐀 𝐋𝐢𝐜𝐞𝐧𝐜𝐞 𝐡𝐨𝐥𝐝𝐞𝐫 https://www.andra.com.au/wp-content/uploads/2020/06/ESP-competitor-declaration_Editable-1.pdf

For information on completing the ESP forms https://www.andra.com.au/wp-content/uploads/2020/10/2.4-ESP-Form-Completion-Guide_FINAL_20201021.pdf

𝐒𝐔𝐏𝐏𝐎𝐑𝐓 𝐃𝐑𝐀𝐆 𝐑𝐀𝐂𝐈𝐍𝐆 - 𝐏𝐋𝐄𝐀𝐒𝐄 - 𝐍𝐎 𝐁𝐘𝐎 𝐀𝐋𝐂𝐎𝐇𝐎𝐋 & 𝐍𝐎 𝐆𝐋𝐀𝐒𝐒 𝐂𝐎𝐍𝐓𝐀𝐈𝐍𝐄𝐑𝐒

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