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2022 Desert Nationals Alice Springs Inland Dragway Nomination Form
ğŸğŸŽğŸğŸ ğƒğžğ¬ğžğ«ğ­ 𝐍𝐚𝐭𝐢𝐨𝐧𝐚𝐥𝐬
𝐒𝐚𝐭𝐮𝐫𝐝𝐚𝐲 𝟐𝟑𝐫𝐝 𝐉𝐮𝐥𝐲 ğŸğŸŽğŸğŸ 𝐚𝐧𝐝 𝐒𝐮𝐧𝐝𝐚𝐲 𝟐𝟒𝐭𝐡 𝐉𝐮𝐥𝐲 ğŸğŸŽğŸğŸ

𝐄𝐧𝐭𝐫𝐲 ğ…ğžğžğ¬
𝐄𝐀𝐑𝐋𝐘 𝐁𝐈𝐑𝐃: $ğŸğŸ“ğŸŽ 𝐄𝐍𝐃𝐒 𝟑𝟏 𝐌𝐚𝐲 ğŸğŸŽğŸğŸ

𝐄𝐧𝐭𝐫𝐲 𝟏𝐬𝐭 ğ‰ğ®ğ§ğž ğŸğŸŽğŸğŸ - 𝟏𝟐𝐭𝐡 𝐉𝐮𝐥𝐲 ğŸğŸŽğŸğŸ
Sportsman Classes $280
Junior Dragster $80
Non Competition $85

$ğŸ‘ğŸŽğŸŽ ğ‹ğšğ­ğž 𝐄𝐧𝐭𝐫𝐲 𝟏𝟑𝐭𝐡 𝐉𝐮𝐥𝐲 ğŸğŸŽğŸğŸ -𝟏𝟗𝐭𝐡 𝐉𝐮𝐥𝐲 ğŸğŸŽğŸğŸ

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

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Email *
Brackets and Entry Fees (see above for Early Bird and Late Entry prices) *
Required
ANDRA Licence Number (Number given by ANDRA) *
I have completed the ANDRA acknowledgement of risk https://www.andra.com.au/risk-statement/ *
Required
First Name *
Last Name *
Date of Birth *
MM
/
DD
/
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.
ğ’ğœğ«ğ®ğ­ğ¢ğ§ğžğžğ«ğ¢ğ§ğ :  
𝐀𝐍𝐃𝐑𝐀 ğ‹ğ¢ğœğžğ§ğœğž 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

ğ’ğ”ğğğŽğ‘ğ“ 𝐃𝐑𝐀𝐆 𝐑𝐀𝐂𝐈𝐍𝐆 - 𝐏𝐋𝐄𝐀𝐒𝐄 - 𝐍𝐎 ğğ˜ğŽ ğ€ğ‹ğ‚ğŽğ‡ğŽğ‹ & 𝐍𝐎 𝐆𝐋𝐀𝐒𝐒 ğ‚ğŽğğ“ğ€ğˆğğ„ğ‘ğ’
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