Telephone: 08 9524 7644           Fax: 08 9524 7633
Postal address: PO BOX 1345, Booragoon WA 6954
E mail: emulti@eliteracing.com.au
 
Application Coupon 

Option # 1:   
 One Payment of $1290 for 12 months Elite Racing Complete membership and get the Elite-Multi Computer Program FREE.

Option # 2:
Click here if you wish to pay by instalments

Don't want to order on-line?   Click here to order by Mail or Fax

Option # 1: On-line Order Form     Note: Please use the TAB key (Not Enter Key)

Title:

First Name:

Last Name:

Address:

City/Town:

State:

Post Code:

Phone #1:

Phone #2:

Fax:

E-mail:

 

I wish to pay by: Please select Payment option.

Credit Card Details (Not required if paying by Cheque or Money Order)

Credit Card Type:

Number:

Expires:

 (Format:  07/06 or 11/05 etc)

Name On Credit Card:

Amount:

 

Message or instructions to Elite Racing Data Pty Ltd: