Cover type

Is your bike registered?

Year

Make

Model

Purchase price

$

Including non-standard accessories and modifications

Purchase date

How is your bike stored overnight?

Address of where you usually keep your bike overnight?

Postcode

Date of birth

Licence type

Years held

Is you motorcycle under finance?

Yes

No

How many kilometres do you ride per year?

Is the main rider a member of any of the listed motorcycle clubs?

Email

Mobile

Work phone

Home Phone

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