Become A Member

Fair Deal Ride Share Club Membership Application and Declaration Form

Welcome to Fair Deal Ride Share Club! By becoming a member, you'll gain access to dependable protection, priority service, and the invaluable guidance of our knowledgeable team. If you haven't yet received a quotation, please take a moment to complete the form below and secure coverage without delay.

Customer Details

Email *

First Name *

Last Name *

Phone Number *

Address *

Suburb

Post Code *

State *

Vehicle Details

Vehicle *

Rego No *

Year *

Body Type *

Colour *

State *

Vin

Is your vehicle value over $40,000?

Cover Details

Insurance Type *

Policy Type

Period

Premium

Driver Details

Driver is the same as the customer above

First Name *

Last Name *

Date of Birth *

Licence type *

Years licence held *

Phone Number

Licence No

Licence Expiry

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