Business Information

Please allow up to 2 business days for your application to be received.

Business Trading Name *

Applicant First Name *

Applicant Last Name *

Applicant Email Address *

Applicant Mobile *

Workshop Email Address *

Workshop Phone *

Street Address *

City *

State *

VIC, TAS, QLD, NSW, ACT

Country

Postal code *

Business ABN *

MVRL Number

Business Website

How many years has your Business been running? *

About You and your business *

Tell us who you are, what you specialise in & your experience.

Photo of outside your workshop *

This will be used on the Member Map

Does your company have social media sites, if yes which ones?

Facebook

Instagram

Workers Compensation *

Yes, I have workers compensation.

Upload A Copy of Your Current Public Liability *

Accepted file types: jpg, pdf, Max. file size: 20 MB.

Is your Business part of a banner group? eg Repco, Ultra Tune etc. *

Yes

No

If you are part of a banner group which one? *

Is your Business part of a Franchise Agreement? *

Yes

No

If yes, who is your Franchise Agreement with? *

Are you a member of Capricorn? *

Yes

Not Applicable

What is your Capricorn Number? *

Membership Approved *

Capricorn Billing

Upon approval of your membership, the invoice will be sent to your Capricorn account. Otherwise, you will receive an invoice with a payment link.

For your AASDN Branded Shirt My Size Would be? *

Why would you like to join AASDN East Coast? *

How Did You Hear About AASDN East Coast? *

Were you referred by an AASDN Member? *

Please Provide Name Of Referral *

I agree to the Terms and Conditions provided by AASDN East Coast.