Application

Please fill out and submit the application below, and then proceed to the membership tab to purchase the corresponding green, white, or checkered package. Feel free to include any questions in the "message" box. Click Here for Printable Application.

Name

Address

City-State

Zip

Phone Number Type of Car or Division

Signature* (please print name)

Date

Please select a membership package: Green Membership - $279
White Membership - $349
Checkered Membership - $429

* = required field - No age limit. - Cars must have seatbelts and rollover protection. - Gokarts, cycles, four wheelers, snowmobiles are not covered. - STIDA covers internationally in addition to the US.

Message

Don't forget to purchase your corresponding membership under the "membership" tab at the top of the page.